SCI Flashcards
SCI
acquired lesions are far less common in children vs adults
Skeletally immature patients may develop orthopedic issues
Epidemiology
In US: 20 cases per million children
Common causes: mva, sports, falls, and violence (child abuse)
MVA- m/c in infants,
— in children younger than 4 y/o = high level cervical lesion
— lap belt- 5-8 y/o (thoracolumbar junction with significant retroperitoneal injury
— teens- cervical level lesion
Falls- 2-9 y/o
Sports- 10-14 y/o
Boys 2x more likely to sustain SCI compared to girls
African American exhibit higher incidence with asian demonstrating significantly lower incidence
Survival Rate:
- 83% normal life expectancy with incomplete
- 50% with high cervical injury without vent dependence–primary mortality d/t respiratory complications
Developmental Anomalies of cervical vertebrae = place SC at increased risk for injury
- AA instability, DS, JRA, os odontoideum (failure of fusion of odontoid), achondroplasia
Nontraumatic myelopathy- tumor (primarily intramedullary tumors), transverse myelitis, epidural abscess, AV malformation, MC, and SCI due to thromboembolic disorder
Prevention
Proper use of restrains in vehicles, water safety,
Seat belt- cross pelvis and at clavicle
Booster seat- until lap belt and shoulder harness fit correctly– typically when child is 4’9”, 8 y/o, or weighs 80lbs
Rear facing- until 20 lbs or 12 months old—remain rear facing as long as possible
Advances in Recovery
Spinal cord regeneration research– focuses on neuroprotection, neuroplasticity, neuroregeneration, and cellular transplant therapy
Pharma intervention to stop secondary events and protect compromised cells
–corticosteroids administered in acute phase- decreased edema and limits cell death
Hypothermia- used to decrease damage
Stem Cell Transplants
PT can assist in evaluating evidence regarding potential therapies
