Pediatric Spina Biﬁda and Spinal Cord Injury

J. Pers. Med, 2022 · DOI: 10.3390/jpm12060985 · Published: June 17, 2022

Simple Explanation

Spina biﬁda (SB) and spinal cord injury (SCI) are common neuromuscular disorders in children, requiring special attention due to their unique characteristics. Children with these conditions are at risk of complications like spinal cord tethering and pressure injuries. Proper management of bladder and bowel function is vital for their well-being and social integration. Spina biﬁda is a birth defect where the spine doesn't close completely during pregnancy, potentially damaging the spinal cord and nerves. This can lead to lifelong medical needs. The incidence of SB has decreased due to folic acid supplementation and early detection during pregnancy. Spinal cord injuries (SCI) in children are relatively rare compared to adults and can be caused by trauma or other factors. Children's spines have different anatomical features than adults, making them more susceptible to certain types of injuries. Motor vehicle accidents are the most common cause of SCI in young children.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 1 evidence (MOMS study)

Key Findings

1
Early diagnosis of SB during pregnancy allows for various management options, including in-utero surgical repair, which has shown benefits such as reduced need for shunting and improved lower extremity function, although it carries risks like premature labor.
2
Children with SB often experience orthopedic issues due to muscle imbalances and weakness, leading to deformities in the spine and lower extremities. Neuromuscular scoliosis is common, and interventions range from bracing to surgical options like spinal fusion.
3
Children with spinal cord injuries may experience a range of complications, including neurogenic bowel and bladder, neuromuscular deformities, and metabolic impairments. Vital signs and bladder capacity are age-dependent and must be considered in management.

Research Summary

Pediatric spina biﬁda (SB) and spinal cord injury (SCI) are unfortunately common in our society, and their unique ﬁndings and comorbidities warrant special consideration. Children with SB or SCI require close monitoring with a multi-disciplinary team approach and appropriate tools, opportunities, and resources to allow them to succeed at any age. Individualized transition plans to adulthood are essential for increasing independence, autonomy, and community integration for individuals with SB or SCI.

Practical Implications

Multidisciplinary Care

Emphasizes the importance of a comprehensive, multidisciplinary approach to managing SB and SCI, involving specialists from various fields to address the complex needs of these patients.

Early Intervention

Highlights the significance of early diagnosis and intervention for SB, including prenatal care, surgical options, and postnatal management, to improve outcomes and reduce complications.

Transition Planning

Stresses the necessity of individualized transition plans for adolescents with SB and SCI to promote independence, autonomy, and community integration as they transition into adulthood.

Study Limitations

1
The paper is a review and does not present original research data.
2
Specific study duration and participant details are not included, limiting the analysis of long-term outcomes.
3
The review acknowledges variability in practice, suggesting a lack of universally accepted standards for certain interventions.

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