A retrospective case series of pediatric spinal cord injury and disease in Victoria, Australia

Abstract

Study design: Retrospective case series.

Objective: This study aimed to describe the incidence and etiology of pediatric spinal cord disorders (SCD) at The Royal Children's Hospital (RCH).

Summary of background data: Spinal cord disorders is rare in children, but those who sustain SCD typically require significant ongoing resources to optimize long-term outcomes. The incidence of pediatric SCD has been reported in Europe, North America, and South America; however, no previous reports are available for Australia.

Methods: A retrospective case series of consecutive admissions with SCD was identified using the International Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification, diagnostic codes relating to initial onset of SCD for both traumatic and nontraumatic conditions. Potential cases admitted to RCH between January 1, 2000, and June 30, 2010, were identified and the RCH Trauma Registry was cross-checked to improve accuracy of case attainment.

Results: A total of 103 patients were admitted during the study period. Most patients (n = 68, 66%) had a nontraumatic SCD and were male (n = 68, 66%). Of the 68 patients who sustained nontraumatic spinal injuries, the majority (n = 40, 59%) were a result of neoplasm or transverse myelitis (n = 15, 22%) or other diseases of the spinal cord (n = 12, 18%). Thirty-five children were admitted after traumatic injury and more than half of these (n = 19, 54%) were involved in motor vehicle accidents, followed by sporting injuries (n = 8, 23%), falls from height (n = 7, 20%) and assault (n = 1, 3%). The average incidence of traumatic SCD and nontraumatic SCD during the study period was estimated at 3.8 and 6.5 per million children younger than 15 years, respectively.

Conclusion: The incidence of pediatric SCD at RCH is lower than reports from Europe and the United States but may be comparable on a population basis. The incidence of nontraumatic pediatric SCD is approximately double that of traumatic SCD.

Level of evidence: 3.