소아의 척추 외상
Spinal Cord Injury without Radiographic Abnonnalities in Chi1dren
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Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury withoutradiographic abnormality(SCIWORA) indude flexion, hyperextension, longitudinaldistraction, and ischemia. Inherent elasticity of the vertebral column in infants andyoung children, among other age-related anatomical peculiarities, render thepediatric spine exceedingly vulnerable to deforming forces. The neurologicallesions encountered in this syndrome include a high incidence of complete andsevere partial cord lesions. Children younger than 8years old sustain more seriousneurological damage and suffer a larger number of upper cervical cord lesions thanchildren aged over 8 years. Of the children with SCIWORA. 52% have delayedonset of paralysis up to 4 days after injury, and most of these children recalltransient paresthesia. numbness. or subjective paralysis. The long-term prognosisin cases of SCIWORA is grim. Most children with complete and severe lesions donot recover; only those with initially mild neural injuries make satisfactory neurological recovery.
Abstract
Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury withoutradiographic abnormality(SCIWORA) indude flexion, hyperextension, longitudinaldistraction, and ischemia. Inherent elasticity of the vertebral column in infants andyoung children, among other age-related anatomical peculiarities, render thepediatric spine exceedingly vulnerable to deforming forces. The neurologicallesions encountered in this syndrome include a high incidence of complete andsevere partial cord lesions. Children younger than 8years old sustain more seriousneurological damage and suffer a larger number of upper cervical cord lesions thanchildren aged over 8 years. Of the children with SCIWORA. 52% have delayedonset of paralysis up to 4 days after injury, and most of these children recalltransient paresthesia. numbness. or subjective paralysis. The long-term prognosisin cases of SCIWORA is grim. Most children with complete and severe lesions donot recover; only those with initially mild neural injuries make satisfactory neurological recovery.