Adults with pediatric-onset spinal cord injury: part 2: musculoskeletal and neurological complications.
OBJECTIVE
To determine the prevalence of musculoskeletal and neurological complications of adults with pediatric-onset spinal cord injuries (SCI), and their association with demographic, impairment, and functional limitation factors.


METHODS
Structured interview including standardized measures.


METHODS
Individuals who sustained SCI at < or = age 18 years and were > or = age 24 years at interview.


METHODS
Prevalence of musculoskeletal and neurological complications: fractures during the past 3 years; scoliosis; heterotopic ossification; hip dislocation or contractures; ankle contractures or pain; shoulder pain; elbow contractures or pain; pain at other sites; neurological deterioration; syringomyelia; and spasticity since injury.


RESULTS
The 216 individuals who were interviewed had mean age at injury of 14 years and mean age at follow-up of 29 years. Most common complications were pain at any site (69%), spasticity (57%), shoulder pain (48%), scoliosis (40%), hip contractures (23%), and back pain (22%). There were no statistically significant associations between gender and the complications. Whites were more likely than nonwhites to experience pain. Younger age at injury was significantly associated with scoliosis and hip subluxation, and older age at injury was associated with ankle pain and spasticity. Older age at follow-up and longer duration of injury were both associated with elbow and shoulder pain, fractures, and neurological deterioration. Longer injury duration was also associated with hip subluxation and scoliosis. Ankle pain, elbow contractures, and spasticity were more common in those with tetraplegia, and hip contractures were associated with paraplegia. American Spinal Injury Association motor scores were significantly lower in those with elbow contractures and spasticity, and significantly higher in those with hip contractures and neurological deterioration.


CONCLUSIONS
Musculoskeletal and neurological complications are common sequelae among adults with pediatric-onset SCI. Demographic, impairment, and functional limitation factors are associated with these complications and can identify at-risk individuals.
Shriners Hospitals for Children, Chicago, Illinois, USA. lvogel@shrinenet.org
Lawrence C
LC
Vogel
Katherine A
KA
Krajci
Caroline J
CJ
Anderson
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000209:etiology*; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology*; D013997:Time Factors