Article

AIM: To determine the epidemiology and complications of spinal cord injuries
(SCIs) in children injured at 5 years of age and younger who were seen between
1981 and 2008 at a children's hospital in the USA. METHOD: Complications studied
were scoliosis, hip dysplasia, latex allergies, autonomic dysreflexia, pressure
ulcers, spasticity, deep venous thrombosis, and kidney stones. Demographic and
injury-related factors included age at injury, etiology, level of injury,
American Spinal Injury Association Impairment Scale (AIS), and SCIs without
radiological abnormalities (SCIWORA). RESULTS: Of the 159 individuals seen (92
males, 67 females) median age at injury was 2 years (range 0 y-5 y 11 mo).
Forty-nine percent were injured in vehicular accidents, 60% had complete
injuries, 66% had paraplegia, and 72% had SCIWORA. Ninety-six percent developed
scoliosis, 57% had hip dysplasia, and 7% had latex allergy.
Thirty-four percent
with injuries at or above T6 experienced autonomic dysreflexia, 41% developed
pressure ulcers, and 61% experienced spasticity. Of those without bowel or
bladder control, 82% were on intermittent catheterization and 69% were on a bowel
program. Median age of initiating wheelchair use was 3 years 4 months (range 1 y
2 mo-12 y 5 mo). Twenty-four were community ambulators, and they were more likely
to have AIS D lesions (half the key muscle functions below the level of injury
have a muscle grade 3 or greater) and less likely to have skeletal complications.
INTERPRETATION: The epidemiology, complications, and manifestations of SCIs in
children injured at a young age are unique and differ distinctively from
adolescent and adult-onset SCIs.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith Press.
- Enfant

Langue : ANGLAIS