Pediatric Spinal Cord Injury: A Review

Children, 2023 · DOI: https://doi.org/10.3390/children10091456 · Published: August 26, 2023

Simple Explanation

This review discusses spinal cord injuries (SCIs) in children, which present unique challenges due to the developing anatomy and physiology of the pediatric spinal cord. It covers the causes, diagnosis, management, and rehabilitation of SCIs in children, highlighting differences from adult SCIs and the need for specialized approaches. The developing pediatric spinal cord exhibits distinct structural characteristics, which affects how it responds to injury. The pediatric spinal cord is more pliable and elastic, leading to different injury patterns and potential for recovery compared to adults. Treatment strategies must consider children’s growing bodies to ensure optimal functional outcomes. The review explores the current knowledge surrounding pediatric SCIs, including recent advancements, unresolved challenges, and promising interventions. It aims to provide a comprehensive overview of the unique aspects of pediatric SCIs, their clinical manifestations, underlying mechanisms, and potential therapeutic strategies.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
The anatomy of the pediatric spine differs from adults due to ongoing skeletal maturation and CNS development, impacting injury patterns and management.
2
The etiology of pediatric SCIs often differs from adults, with non-traumatic causes like congenital anomalies and tumors being more common in children, whereas traumatic injuries are more prevalent in adults.
3
SCIWORA (spinal cord injury without radiographic abnormality) is a unique concern in pediatric patients, emphasizing the importance of MRI and careful clinical evaluation.

Research Summary

Pediatric spinal cord injuries present unique challenges due to anatomical and physiological differences compared to adults. Diagnosis requires specific imaging considerations, and classification systems need modifications for younger children. Management strategies often lean towards conservative approaches, considering the child's growth and potential complications from surgery. Steroid therapy and cardiovascular management require careful attention due to the limited data in pediatric populations. Rehabilitation focuses on mental, physical, and social health, with a goal of returning to school and community integration. Advances in rehabilitation engineering, such as brain-computer interfaces and exoskeletons, show promise for improving independence.

Practical Implications

Clinical Management

Tailor diagnostic and treatment approaches to the unique anatomical and physiological characteristics of pediatric spines.

Rehabilitation Strategies

Focus on rehabilitation programs that address mental, physical, and social well-being, aiming for school reintegration and community participation.

Future Research

Prioritize research on pediatric-specific interventions, including cell-based therapies and pharmacological agents, to improve outcomes and quality of life.

Study Limitations

1
Limited data and studies specifically targeting the pediatric population with SCIs.
2
Extrapolation of knowledge and management strategies primarily from adult SCI literature.
3
Lack of standardized guidelines for surgical treatment and pharmacological management in neonates and young children.

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