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Musculoskeletal changes and treatments in paediatric spinal cord disorders: A scoping review
Jamie Ellis1,2, Peter Simm1,3, Adam Scheinberg1,4,5
1Neurodisability and Rehabilitation Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Insights
Musculoskeletal changes in children with spinal cord disorders (SCD) differ from adults, but research is limited. More studies are needed to develop guidelines for better musculoskeletal health outcomes in pediatric SCD patients.
Area of Science:
- Pediatric Orthopedics
- Neurorehabilitation
- Spinal Cord Injury Research
Background:
- Spinal cord disorders (SCD) significantly impact musculoskeletal development and function in children.
- Understanding these changes is crucial for effective management and long-term outcomes.
Purpose of the Study:
- To review structural and functional musculoskeletal changes in pediatric patients with SCD.
- To identify and evaluate associated treatment strategies for these musculoskeletal complications.
Main Methods:
- A systematic scoping review of literature from January 2000 to June 2024.
- Searched major databases (PubMed, EMBASE, MEDLINE) and grey literature.
- Included studies with at least 50% pediatric cohort (under 18) or stratified pediatric data on SCD musculoskeletal effects and interventions.
Main Results:
- Forty-five reports were included, identifying key themes: Physiological Parameters, Musculoskeletal Complications, and Interventions.
- Musculoskeletal changes in pediatric SCD differ from adults, though underlying mechanisms remain unclear.
- Current intervention studies are underpowered and not yet ready for routine clinical application.
Conclusions:
- There is a significant lack of monitoring and treatment guidelines for musculoskeletal health in pediatric SCD.
- Comprehensive research is essential to develop evidence-based guidelines.
- Improved guidelines are imperative for enhancing musculoskeletal outcomes in children with SCD.
Purpose:
This study aimed to highlight the structural and functional musculoskeletal changes and associated treatment strategies in paediatric patients with spinal cord disorders (SCD).
Methods:
A systematic scoping review was conducted whereby PubMed, Excerpta Medica Database and MEDLINE Ovid databases, and grey literature were searched for articles published between January 2000 and June 2024. Study criteria included at least 50% of participant cohort being children aged under 18 years at time of SCD diagnosis, investigating the musculoskeletal effects of SCD in children, and related management or interventional strategies. Reports in which paediatric or SCD participants were less than 50% of the cohort were included if results were appropriately stratified. Included reports underwent descriptive analysis.
Results:
Forty-five reports were eligible for inclusion. Physiological Parameters, Musculoskeletal Complications, and Interventions were the main themes identified. It was observed that musculoskeletal changes following SCD can differ in children compared to their adult-injured counterparts, but the mechanisms underlying these differences are not known. Intervention studies that have been performed are important, but underpowered, and cannot yet be translated into routine care.
Conclusion:
Monitoring and treatment guidelines for musculoskeletal health in this population are scarce. Comprehensive research efforts are required to facilitate guideline development, which will be imperative in improving musculoskeletal outcomes following paediatric SCD.
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