Demographic and injury characteristics of spinal cord injury in 275 children

Abstract

Objective To study the demographic and injury characteristics of pediatric spinal cord injury(SCI) in children less than 14 years old in order to provide the guide for its prevention and treatment. Methods A retrospective study was performed and a total of 275 cases of children (less than 14 years old) with SCI were identified in China Rehabilitation Research Center(CRRC) from January 1989 to December 2014.The clinical information including gender, age, causes of injury, date of injury and injury condition were analyzed. Results Among 275 cases(male 111 cases, female 164 cases), 48.0% of the cases were 4.0-7.0 years old (132/275 cases), including 93 female cases (70.5%, 93/132 cases). Transport activities(74 cases, 26.9%), non traumatic causes(72 cases, 26.2%), sports and leisure activities (70 cases, 25.5%) were the main causes of SCI.Significant difference was observed in a number of patients in sports between 2003-2014 group (28.0%, 65/232 cases) and 1987-2002 group(11.6%, 5/43 cases)(χ2=5.135, P=0.023). The largest gender gap among kids was doing sports (7 male cases, 63 female cases), and the chief reason for children aged 4.0 to 7.0 years was also sports (48.2%, 55/114 cases). Patients suffered with SCI without radiologic abnormality (SCIWORA), in greater number (69.5%, 141/203 cases), and 121 (85.8%, 121/141 cases) patients were thoracic cord injury without radiologic abnormality(TCIWORA). Sports was the main cause of injury (64.1%, 50/78 cases) for 4.0 to 7.0 years old children (64.5%, 78/121cases) who were the greatest number of patients with TCIWORA.The earliest case of sports occurred in 1995, which happened nationwide each year since 2001.Spine hyperextension (90.0%, 63/70 cases) was the most common in sports, which caused 62 patients with SCIWORA (98.4%, 62/63 cases) including 47 children with complete thoracic cord injury (75.8%, 47/62 cases), and it often occurred in summer and autumn. Conclusions Sports injury was the most common cause of SCI children in CRRC nearly 12 years.The incidence of this damage was growing up and the girl(4-7 years old) because of spine hyperextension in sports(bend down in dancing practice) was the largest proportion of children with SCI.This severe damage which often resulted in complete thoracic cord injury should arouse more attention in clinic.The main crowd protection was the children who exercised back bend.This results provided important clues to develop related etiologic study and pointed out that it was needed to collect more information to investigate its injury mechanism. Key words: Spinal cord injury; Spinal cord injury without radiologic abnormality; Retrospective analysis; Child