Spinal cord injuries at birth: a multicenter review of nine cases.
OBJECTIVE
To report a multicenter study of nine cases of children presenting with a birth-related spinal injury.


METHODS
The medical charts of nine patients identified by a questionnaire sent to the members of the French Society of Pediatric Orthopedics (SOFOP) were reviewed.


RESULTS
The pregnancy was uneventful in all cases. The fetal presentation was cephalic in three cases, a breech presentation in four cases, and a face presentation in two cases. The lesion involved the cervical spine in six cases. Three patients presenting upper cervical injuries died before the age of six years. The six remaining patients experienced no neurological improvement.


CONCLUSIONS
These rare conditions occur during difficult deliveries with abnormal presentations, the most common being a breech presentation with entrapment of the fetal head. In a child with hypotonia, flaccid quadriplegia or high thoracic paraplegia after a difficult delivery, a spinal cord injury must be suspected and plain radiographs and MRI must be performed.
Department of Pediatric Orthopedics, Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Paris, France. raphael.vialle@trs.aphp.fr
Raphaël
R
Vialle
Claire
C
Piétin-Vialle
Brice
B
Ilharreborde
Stéphane
S
Dauger
Matthieu
M
Vinchon
Christophe
C
Glorion
D001946:Breech Presentation; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D005602:France; D006801:Humans; D007231:Infant, Newborn; D007746:Labor Presentation; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011859:Radiography; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*