Clinical Audit Determining Standard of Care for Musculoskeletal Health in Children With Spinal Cord Disorders

Area of Science:

• Pediatric Orthopedics
• Neurology
• Rehabilitation Medicine

Background:

• Pediatric spinal cord disorders (SCD) are rare but severe conditions.
• Limited evidence exists on their impact on musculoskeletal health management in children.
• This study addresses this gap by examining SCD characteristics and related complications.

Purpose of the Study:

• To investigate the relationships between spinal cord disorder characteristics and musculoskeletal complications in pediatric patients.
• To identify risk factors associated with specific musculoskeletal issues in children with SCD.

Main Methods:

• Retrospective review of medical records for 100 pediatric patients with SCD (diagnosed 2010-2022).
• Data collected included demographics, SCD etiology (traumatic vs. non-traumatic), and presence of hypercalcemia, fractures, scoliosis, hip dysplasia, spasticity, contractures, and vitamin D status.
• Statistical analysis using odds ratios (OR) and 95% confidence intervals (CI) to assess associations.

Main Results:

• Scoliosis (41%), spasticity (32%), and contractures (27%) were common complications.
• Nonambulant status significantly increased the risk of scoliosis (OR 11.69), hip dysplasia (OR 55.64), contractures (OR 10.72), and spasticity (OR 3.19).
• Hypercalcemia was associated with male patients (OR 4.07) and wheelchair users (OR 6.77).

Conclusions:

• Children with SCD are highly susceptible to diverse musculoskeletal complications.
• Nonambulatory status is a critical risk factor for multiple orthopedic issues.
• Comprehensive data on traumatic and non-traumatic SCD etiologies and their musculoskeletal sequelae are provided.