A Narrative Review of Pediatric Nontraumatic Spinal Cord Dysfunction

Top Spinal Cord Inj Rehabil, 2019 · DOI: 10.1310/sci2502–112 · Published: January 1, 2019

Spinal Cord Injury Pediatrics Rehabilitation

Simple Explanation

This article reviews key issues related to spinal cord dysfunction (SCDys) in children that are not caused by trauma. SCDys in adults is often due to degeneration, tumors, vascular issues, infections, or inflammation. The review discusses the lack of a standard term for non-traumatic spinal cord damage, the history of SCDys with a focus on pediatric conditions, and the classification of SCDys based on international data sets. Important clinical rehabilitation principles specific to children with SCDys are highlighted, along with prevention strategies and research challenges.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative Review

Key Findings

1
There is no internationally accepted term for spinal cord damage not due to trauma, which hinders literature searches and comparability of research.
2
The median SCDys incidence rates for the global regions were Australasia, 6.5/million population/year; Western Europe, 6.2/million population/year; and North America, high income, 2.1/million population/year.
3
SCDys in children is most commonly caused by tumors (30%-63%) and inflammatory/autoimmune conditions (28%-35%).

Research Summary

This narrative review addresses seven key issues related to pediatric non-traumatic spinal cord dysfunction (SCDys), including terminology, history, classification, epidemiology, rehabilitation principles, prevention, and research trends. The lack of a standardized term for non-traumatic spinal cord damage complicates research efforts. The review also summarizes the global epidemiology of pediatric SCDys, highlighting the incidence, prevalence and etiology. Unique clinical rehabilitation issues for children with SCDys are discussed, emphasizing the importance of etiology-specific considerations and the role of the rehabilitation physician in diagnosis. Opportunities for prevention of SCDys, such as folic acid supplementation to prevent spina bifida, are also highlighted.

Practical Implications

Standardize Terminology

Adopting a universally accepted term for non-traumatic spinal cord damage will improve literature searches and allow for better comparison of research findings.

Improve Data Collection

Implementing the International SCI Data Sets for Non-traumatic SCI in clinical practice and research will facilitate better epidemiological and prevention studies.

Enhance Prevention Strategies

Promoting periconceptional folic acid supplementation and ensuring prompt diagnosis and treatment of spinal tumors and infections can reduce the incidence of pediatric SCDys.

Study Limitations

1
Scarcity of quality epidemiology studies, especially from non-developed regions.
2
Data quality was generally not high in the reviewed studies.
3
The ISNCSCI is not appropriate to use in children younger than 6 years old.

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