Post-traumatic syringomyelia producing paraplegia in an infant.
BACKGROUND
Post-traumatic syringomyelia is described in adults after spinal trauma but extremely rarely seen in children, especially in the first year of life.


METHODS
We describe a boy who, at the age of 7 months, suffered spinal trauma during a car accident when he was held at his mother's lap and suffered extreme flexion of his torso. He suffered a mid-shaft fracture of his right femur, treated with hip spica for 6 weeks. After removal of the spica, it was noticed that he was not moving his legs, but he had preserved pain sensation in the lower half of his trunk and legs. A spine magnetic resonance scan performed 2 months after the injury showed a compressed wedge fracture of the body of T5 vertebra, kyphosis and a large syringomyelia cavity extending from T4 to T8. He had two operations to control the syringomyelia with laminotomy-laminoplasty, dissection of the arachnoid adhesions initially and drainage of the cavity on the second operation, with only modest success. He remains paraplegic 7 years after the injury. He has received thoracic brace immediately after the first spinal operation, which avoided kyphosis.


CONCLUSIONS
Spinal trauma is rare in the first year of life; hence, post-traumatic syringomyelia is very rarely seen in infants. Nevertheless, it should be suspected after a major trauma, in the presence of paraplegia. Surgical treatment of post-traumatic syringomyelia in young children has the additional consideration of post-laminotomy kyphosis; hence, thoracic brace should be used early.
Sgouros
Spyros
S
Department of Paediatric Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK. S.Sgouros@bham.ac.uk
Sharif
Salman
S
D000063:Accidents, Traffic; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical; D006801:Humans; D007223:Infant; D007796:Laminectomy; D008297:Male; D010264:Paraplegia / Q000209:etiology* / Q000473:pathology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000473:pathology; D016103:Spinal Fractures / Q000150:complications / Q000473:pathology; D013124:Spinal Injuries / Q000150:complications* / Q000473:pathology; D013595:Syringomyelia / Q000150:complications* / Q000473:pathology; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome