Childhood injuries to the head and spine can be serious. While children younger than the age of 10 have the lowest rate of spinal cord injuries, these injuries are not rare. Any type of trauma from a fall, motor vehicle accident or even sports injuries can result in a head and spine injury.
Dr. Michael Cools, chief of pediatric neurosurgery at Children’s Hospital of Michigan, said there are a handful of things parents should know when it comes to spinal injuries in children.
What is a pediatric spine trauma?
“Spine trauma is a sudden injury to the spinal cord, bones of the spine or nerves that can affect the body’s ability to move or feel,” Cools said. “This condition varies, depending on what caused the trauma and which parts of the spine were involved.”
He said it can range from injured ligaments and fractured bones to nerve injuries that affect how various parts of the body move.
“In children under age 8, we most often see spinal injuries close to the head caused by falls and car accidents. Older children tend to have spinal trauma lower in the back caused by car accidents or sports, particularly injuries due to bike riding, horseback riding, American football and wrestling.”
Signs and symptoms of a pediatric spinal trauma
“We have concerns about an injury to the spine any time a patient has significant neck or back pain following a trauma,” said Cools.
The signs and symptoms of a spinal trauma differ depending on how serious the injury was. They can include:
- Difficulty feeling, moving or controlling the legs and/or arms.
- Difficulty breathing.
- Muscle weakness.
- Difficulty controlling the bladder and bowels.
“If your child has immediate head, neck or back pain or has trouble with feeling or control in his or arms or legs, you should call 911 and avoid moving your child,” Cools said.
While a parent or other bystanders are waiting for emergency personnel, it’s imperative to keep your child’s head and neck immobilized.
“The first thing they should do is call 911 to get first responders to the scene. Next, they should avoid moving the child unless there is an immediate external threat. They should attempt to keep the head and neck as still as possible until first responders arrive. While the impulse to cradle and comfort the child, or to move them to a different position or place, is understandable, it is essential that they are not moved by anyone other than trained medical personnel.”
If there is an injury to the bones or ligaments of the spine, there may be abnormal movement of these bones, so attempts to move the child may result in injury to the spinal cord. It is also important to know that any trauma that results in loss of consciousness is likely significant enough to cause an injury to the spine.
“If someone is unconscious after a trauma, we treat them as if they have a spinal injury until we can rule it out.”
Treatment and recovery for a pediatric spinal injury
Treatment for a child’s trauma-related spine injury will depend on the child’s individual needs.
“Some children do not require any treatment, while others require a brace to allow the bone to heal,” Cools said. “In children whose trauma is significant enough to cause instability in the spine, surgery in the form of a spinal fusion is often necessary to allow the bones to heal and prevent injury to the spinal cord. If a child’s spinal cord is injured, emergency surgery may be needed to relieve the pressure on the spinal cord.”
Treatment is individualized depending on the extent of the condition and the presence of other injuries in the child.
Children with spinal injuries often require physical therapy and rehabilitation to regain or maintain function and movement during recovery. Another type of rehabilitation includes occupational therapy. Your child’s doctor will tailor a rehabilitation program to meet your child’s needs.
“Recovery varies by the significance of the injury. In patients with injuries to the spinal cord, they may have persistent weakness and numbness, even following surgery. These patients often need intensive inpatient rehabilitation to help regain strength and function. Fortunately, children have the ability to recover from spine injuries better than similarly injured adults. Our physical therapists, occupational therapists and rehabilitation doctors at Children’s Hospital of Michigan play a huge role in our multidisciplinary approach to the care of spine injured children.”
Mental health of a child who experiences a spinal injury
After a spinal injury, a child may experience a range of emotions, such as anger, sadness or nervousness.
Any child who has a traumatic injury can have a strong emotional reaction, and injuries to the spine are no different. Younger children may have difficulty understanding what is happening and why they need to wear the brace or have surgery.
“Fortunately, at Children’s of Hospital of Michigan, we have an amazing Child Life team that works with children to help them understand their condition and their medical care,” Cools said. “We also have dedicated pediatric psychologists who see children while they’re in the hospital and follow them afterward to help develop healthy coping strategies.
“Most kids adjust a few weeks after a spinal cord injury, but some kids have stronger, longer-lasting feelings. Talk to someone on your care team -- a counselor, psychologist or social worker -- if your child doesn’t seem to be feeling better, is incredibly sad, often talks about dying or ever talks about self-harm.”
Preventing spinal injuries
According to Children’s Hospital of Michigan, there are several ways parents can help to prevent spinal injuries in their children:
- Ensure your child wears a seat belt and other proper restraints for their age. This is one of the best prevention measures parents can take for spinal cord injuries in children.
- Make homes safer from falls by removing tripping hazards and installing safety gates where appropriate.
- Experts caution that children younger than age 1 should not be carried on bicycles. They also encourage teens to use caution when skateboarding and bicycling, including the use of helmets and avoiding use of headphones while on bikes.
- Instruct children and teens about safety around water to avoid accidents from diving and falling into pools and shallow bodies of water.
To learn more about the orthopedic services at Children’s Hospital of Michigan, visit ChildrensDMC.org/spineservices.