![]() It may be related to the somatotopic organization of the corticospinal tract within the spinal cord. The hallmark of this condition is greater damage to the middle portion of the cord than to the periphery. The typical mechanism is hyperextension injury. There is disproportionately greater motor impairment in upper compared to lower extremities, bladder dysfunction, and a variable degree of sensory loss below the level of injury. The following are incomplete spinal cord syndromes which have typical presentations.Ĭentral cord syndrome is the most common incomplete spinal cord injury which manifests as symmetric incomplete quadriparesis. Therefore, a light touch is preserved to some extent unless there is involvement of both the spinothalamic tracts and the dorsal columns.īeware that children with cervical and high thoracic spinal cord injuries are also at risk for respiratory failure and neurogenic shock. A light touch is transmitted by both the spinothalamic tracts and the dorsal columns. Damage to one side of the dorsal columns causes ipsilateral loss of vibration and position sensation. The dorsal columns are also descending motor pathways which transmit vibration and proprioception. ![]() Damage to this tract results in loss of pain and temperature sensation on the opposite side of the body. The spinothalamic tract is an ascending pathway that transmits pain and temperature sensation. Damage involving this tract causes ipsilateral clinical findings including muscle weakness, spasticity, increased deep tendon reflexes, and Babinski sign. The corticospinal tract is a descending motor pathway. The three most important tracts in the spinal cord are corticospinal tracts, spinothalamic tracts, and dorsal (posterior) columns. Secondary injury occurs due to various vascular and chemical processes resulting from a primary injury.īefore one evaluates a patient, a basic review of spinal cord anatomy can yield a rapid diagnosis. The mode of injury occurrence can be classified as primary and secondary. Primary injury results from mechanical forces directly due to traumatic impact. This activity highlights the role of the interprofessional team in caring for pediatric patients with spinal trauma. This activity examines when this condition should be considered in differential diagnosis and how to properly evaluate it. Amongst the various levels of injuries, cervical spine injuries are rare in children and occur in less than 1% of these patients due to underlying anatomical differences compared to adults. ![]() ![]() The non-accidental injury is an underreported mechanism therefore, the true incidence of spinal injuries is underestimated. Adolescent boys are at highest risk for injuries. The annual incidence of spinal cord injury is approximately 40 cases per million population. Spinal cord injury involves various levels of the spine. Moreover, up to 5% of patients with a head injury may also have an associated spinal injury, making it an injury with a need for time-sensitive intervention. Quite often when encountering multi-system trauma in a patient, the presence of spinal injury should be highly suspected. A spinal cord injury is a potentially crippling injury which often results in severe and permanent disability.
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