Traumatic spinal cord injury in children: clinical profile and management outcome in a developing country’s rural neurosurgery practice

There is paucity of data-driven study on pediatric traumatic spinal cord injury (SCI) in the developing countries. This study aims to define the clinical profile of pediatric traumatic SCI in a rural tertiary hospital in a sub-Saharan African country. This was a prospective observational study of all children with spinal cord injury managed at our center over a 42-month period. There were 20 patients, comprising 13 males and 7 females with a mean age of 11.5 years. Road traffic crash was the cause in 70% of the cases (motorcycle accident = 45%), and fall from height in 25%. Pedestrians were the victims of the road traffic crash in 42.9% (6/14) of the cases, while 21.4% (3/14) and 28.6% (4/14) were passengers on motorcycles and in motor vehicles, respectively. The cervical spine was the most common location of injury, occurring in 90% of the cases (18/20). Seventy-five percent of the patients (15/20) had transient deficits, but were grossly normal neurologically on examination (American Spinal Cord Injury Association [ASIA] grade E); 2 patients had ASIA D, while 1 patient each had ASIA C, B, and A injuries. All patients were managed nonoperatively. The patients with incomplete deficits improved, while those with complete injury did not make any motor or sensory gain. Road traffic accident, mostly motorcycle crash, was the most common etiology of pediatric SCI in this series, and most of the injuries were located in the cervical spine. Disabling injury constituted a small proportion of pediatric SCI in our practice.