Spinal cord injury in children

[exinilu]

The spinal cord is a long, fragile tubelike structure that begins at the end of the brain stem and continues down to the lower part of the spine. The spinal cord consists of nerves that carry incoming and outgoing messages between the brain and the rest of the body. (See also Spinal Cord.)
Although children younger than 10 years have the lowest rate of spinal cord injuries, such injuries are not rare. Most spinal injuries in children occur in the neck area.
In children younger than 8 years, neck spinal injuries are most commonly caused by motor vehicle crashes, falls, and child abuse. In children older than 8 years, motor vehicle crashes and sports injuries, particularly injuries due to gymnastics, diving, horseback riding, American football, and wrestling, are common causes of spine injuries. Compared with adults, children have distinct anatomic features (such as larger head size-to-body and elasticity of spinal ligaments) that make the structures protecting the spinal cord (including the vertebrae) more flexible. Because these structures are so flexible, the spinal cord can be less protected from being stretched, torn, compressed, or otherwise damaged when the neck is injured. Thus, the spinal cord can be more likely to be damaged even when the vertebrae are not damaged.
Children with spinal cord injury may have brief symptoms such as tingling and weakness. Children may also have shooting pains down the spine or the arms or legs. In about 25% of affected children, onset of symptoms, such as weakness, numbness, other nerve damage, or even complete paralysis, is delayed from 30 minutes to 4 days after injury, making it more difficult for doctors to diagnose spinal cord injury.
Spinal cord injury that is not seen on imaging is related to pulling or stretching of the spinal cord, pressure on the nerves or spinal cord (spinal cord impingement), spinal cord concussion (similar to a brain concussion), and injury to the blood vessels. Injury that is not visible on imaging tests is called

[Agnes]

Although children lt; 10 years have the lowest rate of spinal cord injuries, such injuries are not rare. Most spinal injuries in children occur in the neck.
In children lt; 8 years, cervical spine injuries occur most commonly above C4 and are most commonly caused by motor vehicle crashes, falls, and child abuse. In children gt; #160;8#160;years, injuries at C5 to C8 are more common and are due to motor vehicle crashes and sports injuries, particularly gymnastics, diving, horseback riding, American football, and wrestling. Compared with adults, children have distinct anatomic features (eg, larger head size-to-body, elasticity of spinal ligament capsules) that predispose them to hypermobility of the spinal column without apparent bony injury.
Children with spinal cord injury may have transient symptoms such as paresthesias and weakness. Children may also have lancinating pains down the spine or extremities. In about 25% of affected children, onset of neurologic signs (such as partial neurologic deficits, complete paralysis) is delayed from 30 minutes to 4 days after injury, making immediate diagnosis difficult.
Spinal cord injury without evidence of radiologic abnormality (SCIWORA) is related to direct spinal cord traction, spinal cord impingement, spinal cord concussion, and vascular injury. This type of injury occurs almost exclusively in children and often occurs in the cervical spine. In spinal cord injury without evidence of radiologic abnormality, the patient has neurologic findings suggestive of spinal cord injury (eg, paresthesias, weakness) but normal anatomic alignment, and no bone abnormalities are seen on imaging studies (plain x-rays, CT, and/or MRI).
Children immobilized by SCIWORA or other spinal cord injuries are at risk for complications due to immobility, including decubitus ulcers, thromboembolic complications, atelectasis and pneumonia, hypertensive autonomic dysreflexia, and complications due to neurogenic bladder, including lower or upper urinary traction infection (secondary to a chronic indwelling catheter), ureteral calculi, vesicourethral reflux, and ultimatelychronic kidney disease.
(See also Spinal Trauma.)