Spinal Cord Injury and Malformations in Children

Abstract

At birth, the spine is fully developed with bone, cartilage, and fair ligamentous stability. The ligaments are fully developed around the age of 8 years. There is no wedging of the vertebral bodies. The cervical musculature, very important in the cervical spine of the adult, is still poorly developed in infants. The head is relatively large and heavy on the cervical spine. Clinical assessment of spinal injuries in children can be particularly challenging. Understanding the history of clinical lesions of the spinal or spinal cord injuries in children can be difficult. Neurological evaluation and classification of spinal cord injury should be made in accordance with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), but the neurological exam is less reliable, difficult to interpret in children, and less useful in children under 4 years old. Some elements of the examination, such as anorectal examinations and pin prick testings, are often difficult to complete and interpret for children under 10 years of age. When assessing motor function, it is important to consider that normal motor strength of a young child is different from that of older adolescent or adults.