Spinal cord trauma in children under 10 years of age: clinical characteristics and prevention.
OBJECTIVE
This study analyzed the clinical characteristics of spinal cord injury (SCI) in children 10 years of age and younger, forms of prevention, and ways to improve treatment.


METHODS
Ninety-three children were reviewed between 1996 and 2009. The variables studied were type, age, cause, neurological level, association between SCI and traumatic brain injury (TBI), arthrodesis surgery, time elapsed between trauma and diagnosis, and causes of death. The statistical evaluations were done using the chi-square and ANOVA scales, in the SPSS program version 11.0.


RESULTS
The most common cause was automobile crash accidents. Getting run over by a car was second (29.1 %), followed by firearm injuries (11.8 %). The thoracic spine was the most commonly impacted area. Evaluation showed that 83.9 % had complete neurological injury. Associated TBI was present in 35.5 % of the cases. Only 21.5 % of the patients required arthrodesis of the spine. In 31.2 % of the cases, myelopathy was not diagnosed at the time of the accident. There was no statistical correlation between TBI and a delayed diagnosis of SCI (p=0.231). Five children (5.4 %) died.


CONCLUSIONS
The study showed that the cause of the trauma is associated to the child's age and that prevention is important. Trauma from automobile crash accidents was the main cause, and, in older children, firearm injuries are an important risk. Spinal cord injury was not always diagnosed in children at the time of accident. Educating family members and training emergency teams to adequately treat children with multiple traumas are measures that can help reduce the incidence of SCIs and neurological damage.
Department of Neurosurgery, SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil. ricardogepp@zipmail.com.br
Ricardo
R
de Amoreira Gepp
Luiz Guilherme
LG
Nadal
D000058:Accidental Falls; D000063:Accidents, Traffic; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D014947:Wounds and Injuries