Spinal Cord Injury - Description

Page Contents

• ICD-9
• Description
• Genetics
• Prognosis
• Prevalence
• Pearls And Alerts
• Helpful Articles

ICD-9

952, spinal cord injury

See SCI ICD9 ( 111 KB) for more details.

Description

Spinal cord injuries (SCI) in children:

• are most commonly caused by motor vehicle accidents; [DeVivo: 2004] [Vitale: 2006]
• occur equally in males and females in young children, but more often in males than females in adolescence; [Vitale: 2006]
• are more likely to occur in the cervical cord in children under 9 years of age [McCall: 2006] because of biomechanical factors, including their relatively large head size;
• are often associated with multi-system trauma (head injury, fractures of pelvis and long bones, visceral injuries);
• are more often due to indirect trauma (such as hyperextension of the neck or back from birth injury, falls, motor vehicle accidents, diving and trampoline accidents, or shaking in non-accidental trauma) than direct trauma because the spinal cord in children is in a relatively protected position;
• are more likely to present as SCIWORA (spinal cord injury without radiographic abnormalities), a condition where the spinal cord MRI shows significant damage but plain radiographs show no injury to bony structures. This type of injury, presumably indirect and usually ligamentous in nature, is seen in approximately one third of spinal cord injuries in children 0-5 years. The proportion decreases dramatically in the higher age groups. [Buldini: 2006] Because late and recurrent neurological deficits have been described after SCIWORA, follow-up spine MRIs are indicated. [Launay: 2005]
• are more likely to show some neurological improvement than those in adults. [Wang: 2004]
• although usually due to injury from trauma, may also be due to transverse myelitis resulting from spinal cord inflammation from para-infectious or autoimmune phenomena (see Transverse Myelitis: Symptoms, Causes and Diagnosis (Transverse Myelitis Association)); tumors; and disruption of vascular supply;

Genetics

There is no genetic component.

Prognosis

Depends on the level and degree of injury and associated complications. In adults, approximately 38% don't survive the initial injury and 87% of those who survived the first year survive 10 years. [Griffin: 1985]

Prevalence

Spinal cord injury in children is rare, accounting for approximately 5% of all SCI. The incidence of new spinal cord injury in children in the United States is 1.99 per 100,000 per year. [Vitale: 2006] Though precise numbers are not available, the prevalence of individuals with sequelae of SCI is much higher than the incidence figure would suggest because many individuals with isolated spinal cord injury survive the initial trauma.

Pearls And Alerts

Helpful Articles

Corbet, Barry.
Spinal Network: The Total Wheelchair Resource Book.
Third Edition ed. Nine Lives Press; 2002. 0971522308
A comprehensive guide to practical information regarding living in a wheelchair.

multiple authors.
Pediatric SCI Supplement.
Journal of Spinal Cord Medicine. 2004;27(Suppl 1).
An excellent collection of articles on pediatric spinal cord injury.

Buldini B, Amigoni A, Faggin R, Laverda AM.
Spinal cord injury without radiographic abnormalities.
Eur J Pediatr. 2006;165(2):108-11. PubMed abstract
This article describes SCIWORA and discusses its incidence and importance in the pediatric spinal cord injury population.

Spinal Cord Injury Module Authors

The authors listed above are responsible for the overall Spinal Cord Injury Module. Authors contributing to individual pages in the module are listed on those pages.

Page Bibliography

Buldini B, Amigoni A, Faggin R, Laverda AM.
Spinal cord injury without radiographic abnormalities.
Eur J Pediatr. 2006;165(2):108-11. PubMed abstract
This article describes SCIWORA and discusses its incidence and importance in the pediatric spinal cord injury population.

DeVivo MJ, Vogel LC.
Epidemiology of spinal cord injury in children and adolescents.
J Spinal Cord Med. 2004;27 Suppl 1:S4-10. PubMed abstract

Griffin MR, O'Fallon WM, Opitz JL, Kurland LT.
Mortality, survival and prevalence: traumatic spinal cord injury in Olmsted County, Minnesota, 1935-1981.
J Chronic Dis. 1985;38(8):643-53. PubMed abstract

Launay F, Leet AI, Sponseller PD.
Pediatric spinal cord injury without radiographic abnormality: a meta-analysis.
Clin Orthop Relat Res. 2005;(433):166-70. PubMed abstract

McCall T, Fassett D, Brockmeyer D.
Cervical spine trauma in children: a review.
Neurosurg Focus. 2006;20(2):E5. PubMed abstract

Vitale MG, Goss JM, Matsumoto H, Roye DP Jr.
Epidemiology of pediatric spinal cord injury in the United States: years 1997 and 2000.
J Pediatr Orthop. 2006;26(6):745-9. PubMed abstract

Wang MY, Hoh DJ, Leary SP, Griffith P, McComb JG.
High rates of neurological improvement following severe traumatic pediatric spinal cord injury.
Spine. 2004;29(13):1493-7; discussion E266. PubMed abstract