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Published on: August 17, 2013
Paediatric Spinal Cord Injury: A Review of Current Management
Chikolum Ejide1, Soham Bandyopadhyay1, Kokila Lakhoo1
1Oxford University Global Surgery Group, University of Oxford, Oxford, GBR.
Insights
Pediatric spinal cord injuries (SCI) require unique management due to children's distinct anatomy. Current guidelines are lacking, necessitating tailored approaches considering factors like head size and ligament laxity for better outcomes.
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Orthopedic Surgery
Background:
- Pediatric spinal cord injury (SCI) differs from adult SCI due to unique anatomical, physiological, and biomechanical factors.
- The pediatric spine presents distinct challenges in injury management.
- A lack of comprehensive, standardized international guidelines exists for managing pediatric SCI.
Purpose of the Study:
- To explore the current management of pediatric spinal cord injuries.
- To identify key considerations for the prehospital, medical, and surgical care of pediatric SCI.
- To highlight the need for further research in this specialized area.
Main Methods:
- A narrative literature review approach was employed.
- A curated selection of pertinent peer-reviewed articles was identified from PubMed and Google Scholar.
- Studies involving pediatric populations (0-18 years) with full article access were included, totaling 26 studies.
Main Results:
- Specific pediatric considerations are crucial for effective SCI management.
- Factors include disproportionate head size, increased ligament laxity, and a higher prevalence of upper cervical injuries.
- The potential development of scoliosis necessitates long-term monitoring.
Conclusions:
- Management strategies for pediatric SCI must incorporate unique pediatric anatomical and physiological characteristics.
- Awareness of these specific factors can significantly improve patient outcomes.
- There is a critical need for more high-quality studies and data in pediatric SCI.
Abstract:
Spinal cord injury (SCI) in the paediatric population is considered a separate entity from the same injury in adults due to the unique anatomical, physiological, and biomechanical properties of the pediatric spine. No comprehensive, standardized, international guidelines currently exist for physicians to follow regarding the management of paediatric spinal cord injuries. Therefore, a narrative literature review approach was employed to explore the management of paediatric spinal cord injuries. The review adhered to the methodological frameworks that entailed identifying a curated selection of pertinent articles on the topic, rather than an exhaustive comprehensive search that is utilised in systematic reviews, this was followed by a reflective interpretation of their content. Using the electronic databases, PubMed and Google Scholar, a search of peer-reviewed studies conducted only in the English language was included. Only studies in which the full article was available were included. Paediatric populations are defined as individuals aged between 0 and 18 years. In total, 26 studies were included in our review. We conclude that it is necessary to factor in specific paediatric considerations, such as disproportionate head size, increased ligament laxity, increased prevalence of upper cervical injury, and future development of scoliosis, in the prehospital, medical, and surgical management of paediatric spinal cord injuries. Clinicians should be made aware of these considerations, as they can improve the outcomes in the paediatric population who suffer from this devastating injury. There is a lack of high-quality studies and data concerning the paediatric population who have sustained SCIs. This literature review highlights the available data and calls for more studies to be conducted in this field.
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