Transection of Spinal Cord: A Rare Obstetrical Complication of Cephalic Delivery

Shulman, Stanford T.; Madden, John D.; Esterly, John R.; Shanklin, Douglas R.

doi:10.1136/adc.46.247.291

Cited by 59 publications

(14 citation statements)

References 16 publications

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“…The site of cord injury in cephalic presentations is nearly always upper cervical, most compatible with the hypothesis of tortion injury [23]. Both case 3 and 5 had upper cervical lesions.…”

Section: Discussionsupporting

confidence: 53%

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Perinatal Spinal Cord Injury: Clinical, Radiographic and Pathologic Features

Rossitch¹,

Oakes

1992

Pediatr Neurosurg

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Perinatal spinal cord injury is a relatively uncommon, but a frequently misdiagnosed disorder. Often, the injury is not suspected and an erroneous diagnosis is made. We present five cases of perinatal spinal cord injury. In four, the referring physicians (including pediatric neurologists) misdiagnosed the condition. In view of these diagnostic difficulties, we review the clinical, radio-graphic and pathologic aspects of these injuries. Serious spinal injuries occasionally occur in the perinatal period. With improving medical care, many infants with less severe injuries are surviving the neonatal period. Therefore, the prompt recognition of neonatal spinal cord damage is essential and allows for optimal treatment of the injured child.

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Section: Discussionsupporting

confidence: 53%

“…Cephalic presentations with spinal cord injuries have been reported less frequently than breech presentations [23,24], In these cases, the mechanism of injury is less obvious. Often there is a history of rotational manipula tion.…”

Section: Discussionmentioning

confidence: 99%

Perinatal Spinal Cord Injury: Clinical, Radiographic and Pathologic Features

Rossitch¹,

Oakes

1992

Pediatr Neurosurg

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“…1,3 Birth-related cervical injuries are usually associated with a breech presentation, 12,15 although they can also occur with cephalic delivery. 87 Cervical injuries in infants and toddlers usually result from falls, motor vehicle accidents, and nonaccidental trauma. 37,38,93 Among children 3 to 10 years of age, falls, bicycle mishaps, and auto-pedestrian accidents account for most injuries, 44,80 and after the age of 10 years, sports and motor vehicle accidents are the biggest culprits.…”

Section: Causes Of Scimentioning

confidence: 99%

Cervical spine trauma in children: a review

McCall¹,

Fassett²,

Brockmeyer³

2006

FOC

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✓ Injuries of the cervical spine are relatively rare in children but are a distinct clinical entity compared with those found in adults. The unique biomechanics of the pediatric cervical spine lead to a different distribution of injuries and distinct radiographic features. Children younger than 9 years of age usually have upper cervical injuries, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. Pediatric cervical injuries are more frequently ligamentous in nature, and children are also more prone to spinal cord injury without radiographic abnormality than adults are. Physial injuries are specific only to children. Radiographically benign findings, such as pseudosubluxation and synchondrosis, can be mistaken for traumatic injuries. External immobilization with a halo brace can be difficult and is associated with a high complication rate because of the thin calvaria in children. Surgical options have improved with the development of instrumentation specifically for children, but special considerations exist, such as the small size and growth potential of the pediatric spine.

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“…The type and severity of injuries sustained in this group, particularly younger children (birth to 8 years), differ from those seen in adults. This includes a higher proportion of cervical injuries [7][8][9][10][11][12][13], and an increased incidence of spinal cord injury without radiographic ab normality (SCIWORA) [5,[14][15][16][17], These differences are likely multifactoriai. However, the most significant fac tor is inherent differences in the pediatric spine com pared to adolescents and adults.…”

Section: Introductionmentioning

confidence: 99%

Spinal Cord Injury without Radiographic Abnormality in Children

Osenbach

Menezes²

1989

Pediatr Neurosurg

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Between 1970 and 1988, 35% of children with traumatic myelopathy demonstrated spinal cord injury without radiographic abnormality (SCIWORA). Young children, especially children under 3 years were particularly vulnerable. Mechanisms of injury were age-specific and included flexion, hyperextension and longitudinal traction. Over 80% of injuries involved the cervical cord. Ninety-five percent of all severe injuries occurred in younger children. Neurologic recovery was directly dependent on the degree of initial neurologic injury. Management included dynamic films to exclude obvious fracture or instability, CT or polytomography to exclude occult fracture, and MRI or CT-myelography to exclude surgical lesions. Cervical immobilization is the cornerstone of therapy for prevention of recurrent episodes of SCIWORA.

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Transection of Spinal Cord: A Rare Obstetrical Complication of Cephalic Delivery

Cited by 59 publications

References 16 publications

Perinatal Spinal Cord Injury: Clinical, Radiographic and Pathologic Features

Perinatal Spinal Cord Injury: Clinical, Radiographic and Pathologic Features

Cervical spine trauma in children: a review

Spinal Cord Injury without Radiographic Abnormality in Children

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