Spinal Cord Injury in Children: What Parents Should Know

What is a spinal cord injury?

Spinal cord injuries in children occur when the spinal cord, a thick bundle of nerve fibres extending from the brainstem to the lower back, is damaged. In children, these injuries are most commonly found in the cervical spine (neck area) and can result from both traumatic and non-traumatic injuries.

Children are at risk of spinal injuries because the protective structures around the spinal cord (spinal column) have not yet fully matured. As a result, the spinal cord inside it may be less protected from compression or tearing due to external forces.

This flexibility can also result in bony injury, which is damage to the vertebrae without a physical fracture. Symptoms may vary widely, ranging from mild sensations like tingling to severe outcomes such as paralysis.

Causes of spinal cord injury in children 

Spinal cord injury in children can come from various factors, such as:

• Falls

• Traffic accidents

• Sports injury

• Child abuse or other types of violence

• Penetrating trauma to the spinal cord

• Abnormalities during birth delivery

• Infection on the spinal cord

• Trauma that blocks circulation to the spinal cord

Types of spinal cord injury

Spinal cord injuries in children are classified according to their location within the spinal column and level of injury. The spinal cord consists of four primary regions with 31 segments, each identified by specific letter-number combinations.

Spinal cord segments

• Cervical spine:

  • Comprising eight nerve pairs (C1-C8), this section runs from the base of the skull to shoulder level and is responsible for head and neck movement.

• Thoracic spine:

  • This segment includes twelve nerve pairs (T1-T12) and extends from the upper back to just below the navel (belly button), which facilitates upper body movement.

• Lumbar spine:

  • Consisting of five nerve pairs (L1-L5), it extends to the area above the buttocks, controlling lower back and leg functions.

• Sacral spine:

  • This section contains five nerve pairs (S1-S5) and is located in the lower back, with nerve roots extending from below the buttocks to the tailbone.

Additionally, there is one coccygeal segment at the very base of the spine.

Level of injury

• Incomplete: 

  • An incomplete injury results in partial damage to the spinal cord, allowing for some sensation, function, and muscle control below the damaged area. 

• Complete:

  • A complete injury indicates a total loss of nerve communication below the trauma location, resulting in the absence of muscle control, sensation, or functionality below the affected area, leading to paralysis.

Common injuries in spinal cord

In children, spinal injuries most frequently occur in the cervical spine, with the specific location varying with age.

For children under 8 years old, cervical spine injuries commonly affect the area above the C4. These injuries are often the result of falls, motor vehicle accidents, or child abuse.

While children older than 8 years are more likely to sustain cervical spine injuries at the C5 to C8 levels, primarily due to traffic accidents and sports injuries.

Common symptoms of spinal cord injury

Symptoms of spinal cord injuries in children can vary depending on the location and level of injury. Here are some common symptoms that may occur following such trauma, including:

• Shooting pain in the injured area.

• Spinal shock.

• Partial or complete loss of muscle movement function in the chest, arms, or legs.

• Partial or complete loss of sensory function in the chest, arms, or legs.

• Breathing difficulty.

• Loss of function in the bowel and bladder.

We understand how challenging it can be to see your child in pain or incapable of moving a bodily part. 

Our healthcare team at Thomson Medical is here to listen to your concerns and provide the support you need. Request an appointment with us to get expert advice and personalised treatment plans tailored to your child's needs.

Diagnosis of spinal cord injury

To diagnose spinal cord injury in children, the doctor will start by discussing the child's symptoms and gathering information about how the injury occurred. They may then conduct a physical examination to assess the sensory function and movements of the body.

During this assessment, special attention is given to cases involving traffic accidents, falls from heights exceeding 3 m, potential abuse, or penetrating trauma.

In addition to that, healthcare professionals can perform imaging tests like X-rays, magnetic resonance imaging (MRI), and CT (computed tomography) scans. This medical care can help healthcare professionals understand the condition better and see if there’s any bone or vertebral fracture.

Treatment options for spinal cord injury

Treatment for spinal cord injuries in children depends on the trauma location, level of injury, the child's response to treatment, and input from the family regarding care options.

However, it is certain that children who have sustained spinal injuries will be taken to a paediatric trauma center, to stabilise the condition and prevent it from worsening. Healthcare professionals may utilise various treatments to facilitate recovery, which include:

• Immobilisation:

  • Medical professionals will use special equipment to immobilise the head and neck to prevent any movement and further spinal cord injury.

• Intensive care unit (ICU):

  • Children with this condition require treatment in an intensive care unit (ICU), where a team of specialists monitors breathing with a mechanical ventilator, maintains blood circulation, and ensures adequate blood flow to the spinal cord.

• Medications:

  • Some medications, such as corticosteroids, may be given to reduce swelling, manage pain, control muscle spasms, and improve bladder and bowel function.

• Physiotherapy:

  • Physiotherapy can help to manage muscle weakness and stiffness while improving movement and mobility skills back to their normal activity.

• Surgical procedure:

  • Surgery is not always required in children with this condition compared to adults. But this procedure may be necessary to stabilise fractured bones in the spine, relieve pressure on the spinal cord, and manage other injuries that occurred.

Because each child's treatment journey is unique, healthcare professionals will work closely with families to develop a personalised care plan that meets the child's specific needs.

Rehabilitation 

Rehabilitation programmes and physical therapy are important for children with spinal cord injuries, as they help prevent muscle stiffness, reduce spasm, and encourage normal use of muscles.

Common rehabilitation programs that can help the recovery of children, such as:

• Teaching kids how to use a wheelchair or crutches.

• Assisting with bladder and bowel management.

• Physical exercises to help the children regain normal muscle strength.

• Emotional support to help children cope with feelings of frustration, fear, sadness, and anger during the recovery process.

To aid in this rehabilitation and help accelerate recovery, regular medical care and check-ups are vital for monitoring progress, preventing complications, and adjusting treatment plans as needed. 

Request an appointment with Thomson Medical today to ensure your child receives expert care and personalised rehabilitation support for a smoother recovery journey.

Complications of spinal cord injury

Complications of spinal cord injury in children can happen when there's a bony injury that wasn't detected on radiographic tools. This radiographic abnormality occurs almost exclusively in children and often occurs in the cervical spine.

Children immobilised by this condition are at risk for complications, including:

1. Bedsores (Pressure ulcers)

   • Injuries to the skin and underlying tissue caused by prolonged pressure on immobilised or damaged areas.

2. Scoliosis

   • An abnormal side-to-side curvature of the spine, characterised by a C- or S-shaped bend that curves to the left or right.

3. Neurogenic bladder complications

   • Includes lower or upper urinary tract infections, often resulting from a chronic indwelling catheter.

4. Neurogenic bladder

   • A condition caused by damage to the brain or spinal cord, affecting the bladder's ability to function properly.

5. Autonomic dysreflexia

   • A syndrome involving an overreaction of the autonomic nervous system to painful sensory input, which can cause sudden and severe symptoms.

6. Syringomyelia

   • A condition where a fluid-filled cyst forms on the spinal cord. Over time, the cyst can enlarge, leading to pain, weakness, and stiffness.

FAQ

What is the most common spinal cord injury in children?

Common spinal cord injuries in children often take place in the cervical spine, with the exact location influenced by the child's age.

For children under 8 years old, cervical spine injuries commonly affect the area above the C4. These injuries are often the result of falls, motor vehicle accidents, or child abuse.

While children older than 8 years are more likely to sustain cervical spine injuries at the C5 to C8 levels, primarily due to traffic accidents and sports injuries.

What are signs of pediatric spinal trauma?

There are some common symptoms that may occur following a spinal cord injury in children, such as:

• Shooting pain in the injured area

• Spinal shock

• Partial or complete loss of muscle movement function in the chest, arms, or legs

• Partial or complete loss of sensory function in the chest, arms, or legs

• Breathing difficulty

• Loss of function in the bowel and bladder

What is the treatment for spinal injuries in children?

To treat this condition, healthcare professionals may employ various treatment methods, including:

• Immobilisation

• Intensive care unit (ICU)

• Medications

• Physiotherapy

• Surgical procedure

Will spinal cord injuries ever be cured?

Currently, there is no method to reverse spinal cord damage, but treatment can help prevent additional injuries and support children in returning to a normal life.

How does a spinal cord injury impact the brain?

A spinal cord injury affects the brain by disrupting the messages it sends to and receives from the body, causing problems with movement and feeling. It can also lead to emotional struggles and changes in how the brain works to adjust to the injury.

How does a spinal cord injury affect the body?

A spinal cord injury affects the body by disrupting the connection between the brain and areas below the injury. This can lead to paralysis, loss of sensation, difficulty controlling muscles, bladder, or bowel, and issues with blood pressure and breathing, depending on the injury's location and severity.

Can a spinal cord injury be life-threatening?

Yes, a spinal cord injury can be life-threatening, especially if it affects areas that control vital functions like breathing or heart rate. Therefore, prompt medical attention and ongoing care are crucial to managing complications and improving survival for your child.

Can you still move after a spinal cord injury?

Movement may still be possible after a spinal cord injury, depending on the severity and location of the damage. With incomplete injuries, some motor function might remain, while complete injuries often result in paralysis below the affected area. Rehabilitation can help maximise mobility.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.