Traumatic Paraplegia in Infancy

The paediatric syndrome of traumatic myelopathy without demonstrable vertebral injury

“…Wolman (1964) suggested a momentary nipping of the cord when vertebrae are displaced, or momentary stretching of the cord over the posterior aspect of the vertebral bodies with forcible flexion. Whatever the exact details, it is persuasive to postulate a transection-type injury which is very much in accord with the clinical histories and visualisation of the cords in Glasauer and Cares' (1972) cases and also in Burke's (1971) two boys who showed the immediate onset uf a complete transverse spinal cord injury syndrome. Glasauer and Cares (1972) report the observation at laminectomy of segmental atrophy of the cord at the level of injury and approximately two-segment level atrophy at autopsy in their other case.…”

“…There is a report of the findings at laminectomy in a second case. Glasauer and Cares (1972) provide details of two infants who sustained complete spinal cord injuries of immediate onset, both remaining complete. In one there is visual evidence obtained at laminectomy, and, in the other, autopsy evidence.…”

“…Burke's 1974 paper provides evidence from laminectomy in one child and from autopsy in another. Glasauer and Cares (1972) provide clinical information in two patients with visual examination of the cord in both. Ahmann et al (1975) provide a very clear history of the gradual evolution of tetraplegia in two children.…”

“…Burke's 1974 paper is of assistance in that it contributes some surgical and autopsy evidence but it does not include any reference to the mechanics of injury nor to the clinical neurological presentations of the two children with incomplete lesions out of a total of 24 patients. The paper of Glasauer and Cares (1972) contributes two good case histories with, in one, macroscopic examination of the cord at laminectomy and, in the other, macroscopic and microscopic examina tion at autopsy. The paper of Ahmann et al (1975) is primarily concerned with the autopsy findings in two children, but there is some aetiological mechanistic information as well as clinical neurological information.…”

Spinal cord injuries in children in British Columbia

“…Burke (1971Burke ( , 1974 and Cheshire (1977) reported a low incidence of spinal fractures in paediatric spinal cord trauma, due to hyperflexion or hyperextension injury. Little is known of the pathological changes to the vertebral column and spinal cord due to the scarcity of material and published autopsies (Burke, 1971(Burke, , 1974Glasauer & Cares, 1972;Cheshire, 1977). Complications following spinal cord injuries in children are similar to those seen in adults, but their severity and incidence differ.…”