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PEDİATRİK POPÜLASYONDA TRAVMATİK SPİNAL KORD YARALANMASI REHABİLİTASYONUNUN DEĞERLENDİRİLMESİ

Yıl 2023, , 542 - 548, 18.12.2023
https://doi.org/10.19161/etd.1221420

Öz

Giriş: Travmatik spinal kord yaralanması (SKY), çocuklarda nadir görülen bir antitedir. Çocuk omurgasındaki anatomik ve biyomekanik farklılıklar nedeniyle yaralanma paternleri, erişkinlere göre farklılık gösterir(1, 2).
Amaç: Travmatik SKY olan pediatrik hastaların sosyodemografik ve klinik özelliklerinin değerlendirilmesidir.
Materyal-Metot: Çalışma, retrospektif tanımlayıcı bir çalışma olarak planlandı. 18 yaş altı, travmatik SKY olan hastalar çalışmaya dahil edildi. Hastaların sosyodemografik ve klinik verileri, komplikasyonları ve rehabilitasyon sonuçları incelendi.
Bulgular: Ocak 2020-Ağustos 2022 tarihleri arasında başvurusu bulunan 13 kız, 19 erkek hasta çalışmaya dahil edildi. Ortalama yaş 151,96±52,81 aydı. Ortalama hastalık süresi 741,06±846,84 gündü. 21 hasta yatarak tedavi almıştı. Ortalama yatış süresi 55,48±40,93 gündü. Hastaların 11’inde yüksekten düşme, 8’inde motorlu araç kazası, 6’sında ateşli silah yaralanması, 5 ‘inde sığ suya dalma, 2’sinde spinal cerrahiye bağlı olarak; 9 servikal, 17 torakal, 6 lomber düzeyde yaralanma tespit edildi. SCIWORA veya SCIWONA tespit edilen hasta yoktu. 19 inkomplet, 13 komplet yaralanma tespit edildi. En sık raporlanan komplikasyonlar; nörojenik mesane (%87,5), nörojenik barsak (%68,8) ve spastisite (%62,5) idi. Hastaların %18,8’i yatak seviyesinde, %18,8’i tekerlekli iskemle seviyesinde, %25’i terapötik ambule, %6,3’ü ev içi ambule, %31,3’ü toplum içi ambule idi.
Sonuç: Pediatrik grupta en sık olarak yüksekten düşmeye bağlı SKY geliştiği, yaralanmanın en sık olarak torakal seviyede olduğu, en sık komplikasyonların nörojenik mesane-barsak, spastisite olduğu ve hastaların büyük orada ambule olduğu saptanmıştır.

Kaynakça

  • 1. Canosa-Hermida E, Mora-Boga R, Cabrera-Sarmiento J, et al. Epidemiology of traumatic spinal cord injury in childhood and adolescence in Galicia, Spain: report of the last 26-years. J Spinal Cord Med. 2019;42(4):423-9.
  • 2. Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325-43.
  • 3. Pang D, Wilberger JE. Spinal cord injury without radiographic abnormalities in children. J Neurosurg. 1982;57(1):114-29.
  • 4. Yucesoy K, Yuksel KZ. SCIWORA in MRI era. Clin Neurol Neurosurg. 2008;110(5):429-33.
  • 5. Choi J-U, Hoffman HJ, Hendrick EB, Humphreys RP, Keith WS. Traumatic infarction of the spinal cord in children. J Neurosurg. 1986;65(5):608-10.
  • 6. Hamilton MG, Myles ST. Pediatric spinal injury: review of 61 deaths. J Neurosurg. 1992;77(5):705-8.
  • 7. Parent S, Mac-Thiong J-M, Roy-Beaudry M, Sosa JF, Labelle H. Spinal cord injury in the pediatric population: a systematic review of the literature. J Neurotrauma. 2011;28(8):1515-24.
  • 8. Brauge D, Plas B, Vinchon M, et al. Multicenter study of 37 pediatric patients with SCIWORA or other spinal cord injury without associated bone lesion. Orthop Traumatol Surg Res. 2020;106(1):167-71.
  • 9. Erhan B, Ulu MO, Gunduz B, Tanriverdi T. Pediatric spine and spinal cord injury in Istanbul: a retrospective analysis of 106 patients. Neurosurg Q. 2005;15(1):21-4.
  • 10. Kim C, Vassilyadi M, Forbes JK, Moroz NW, Camacho A, Moroz PJ. Traumatic spinal injuries in children at a single level 1 pediatric trauma centre: report of a 23-year experience. Can J Surg. 2016;59(3):205.
  • 11. Rush JK, Kelly DM, Astur N, et al. Associated injuries in children and adolescents with spinal trauma. J Pediatr Orthop. 2013;33(4):393-7.
  • 12. Mistry D, Munjal H, Ellika S, Chaturvedi A. Pediatric spine trauma: A comprehensive review. Clin Imaging. 2022.
  • 13. Dogan S, Safavi-Abbasi S, Theodore N, et al. Thoracolumbar and sacral spinal injuries in children and adolescents: a review of 89 cases. J Neurosurg: Pediatrics. 2007;106(6):426-33.
  • 14. Jarvers J-S, Herren C, Jung MK, et al. Pediatric cervical spine injuries—results of the German multicenter CHILDSPINE study. Eur Spine J. 2023:1-9.
  • 15. Atesok K, Tanaka N, O’Brien A, et al. Posttraumatic spinal cord injury without radiographic abnormality. Adv Orthop. 2018;2018.
  • 16. Donenberg JG, Fetters L, Johnson R. The effects of locomotor training in children with spinal cord injury: a systematic review. Dev Neurorehabil. 2019;22(4):272-87.
  • 17. Vogel LC, Lubicky JP. Ambulation in children and adolescents with spinal cord injuries. J Pediatr Orthop. 1995;15(4):510-6.
  • 18. Powell A, Davidson L. Pediatric spinal cord injury: a review by organ system. Phys Med Rehabil Clin N Am. 2015;26(1):109-32.
  • 19. Merenda L, Park Brown J. Bladder and bowel management for the child with spinal cord dysfunction. J Spinal Cord Med. 2004;27(sup1):S16-S23.
  • 20. Garcia-Arguello LY, O'Horo JC, Farrell A, et al. Infections in the spinal cord-injured population: a systematic review. Spinal Cord. 2017;55(6):526-34.
  • 21. Li F, Song M, Xu L, Deng B, Zhu S, Li X. Risk factors for catheter‐associated urinary tract infection among hospitalized patients: A systematic review and meta‐analysis of observational studies. J Adv Nurs. 2019;75(3):517-27.
  • 22. Mitchell BG, Prael G, Curryer C, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control. 2021;49(8):1058-65.
  • 23. Vogel L, Anderson C. Spinal cord injuries in children and adolescents: a review. J Spinal Cord Med. 2003;26(3):193-203.
  • 24. McCarthy J, Chafetz R, Betz R, Gaughan J. Incidence and Degree Of Hip Subluxation/Dislocation In Children With Spinal Cord Injury. J Spinal Cord Med. 2004;27(sup1):S80-S3.
  • 25. Maynard FM. Immobilization hypercalcemia following spinal cord injury. Arch Phys Med Rehabil. 1986;67(1):41-4.
  • 26. Jones T, Ugalde V, Franks P, Zhou H, White RH. Venous thromboembolism after spinal cord injury: incidence, time course, and associated risk factors in 16,240 adults and children. Arch Phys Med Rehabil. 2005;86(12):2240-7.
  • 27. Kim J, Lee JY, Lee E. Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. J Nurs Manag. 2022;30(5):O1-O9.
  • 28. Jaja BN, Jiang F, Badhiwala JH, et al. Association of pneumonia, wound infection, and sepsis with clinical outcomes after acute traumatic spinal cord injury. J Neurotrauma. 2019;36(21):3044-50.
  • 29. D’Hondt F, Everaert K. Urinary tract infections in patients with spinal cord injuries. Current infectious disease reports. 2011;13(6):544-51.
  • 30. Henke AM, Billington ZJ, Gater Jr DR. Autonomic dysfunction and management after spinal cord injury: a narrative review. J Pers Med. 2022;12(7):1110.
  • 31. Unsal-Delialioglu S, Kaya K, Sahin-Onat S, Kulakli F, Culha C, Ozel S. Fever during rehabilitation in patients with traumatic spinal cord injury: analysis of 392 cases from a national rehabilitation hospital in Turkey. J Spinal Cord Med. 2010;33(3):243-8.
  • 32. Yıldız N, Akkoç Y, Erhan B, et al. Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up. Spinal Cord. 2014;52(6):462-7.

EVALUATION OF TRAUMATIC SPINAL CORD INJURY REHABILITATION IN PEDIATRIC POPULATION

Yıl 2023, , 542 - 548, 18.12.2023
https://doi.org/10.19161/etd.1221420

Öz

Introduction: Traumatic spinal cord injury (SCI) is a rare entity in children. Due to anatomical and biomechanical differences in the pediatric spine, injury patterns differ from adults (1, 2).
Objective: To evaluate the sociodemographic and clinical features of pediatric patients with traumatic SCI.
Materials and Methods: The study was a retrospective descriptive study. Patients under the age of 18 with traumatic SCI were included in the study. Sociodemographic and clinical data, complications and rehabilitation outcomes were analyzed.
Results: 13 female and 19 male patients who admitted between January 2020 and August 2022 were included. The mean age was 151.96±52.81 months. The mean disease duration was 741.06±846.84 days. 21 patients were inpatient. The mean hospital stay was 55.48±40.93 days. Due to falls from height in 11, motor vehicle accidents in 8, gunshot wounds in 6, diving accident in 5, spinal surgery in 2 of the patients; 9 cervical, 17 thoracic, 6 lumbar injuries were detected. There were no SCIWORA or SCIWONA. 19 incomplete, 13 complete injuries were detected. The most frequently reported complications were neurogenic bladder (87.5%), neurogenic bowel (68.8%) and spasticity (62.5%). Of the patients, 18.8% were at bed level, 18.8% were at wheelchair level, 25% were therapeutic ambulator, 6.3% were home ambulator, and 31.3% were community ambulator.
Conclusion: In the pediatric group, it was determined that SCI developed most frequently due to falling from a height, the injury was most frequently at the thoracic level, the most common complications were neurogenic bladder-bowel, and most of the patients were ambulator.

Kaynakça

  • 1. Canosa-Hermida E, Mora-Boga R, Cabrera-Sarmiento J, et al. Epidemiology of traumatic spinal cord injury in childhood and adolescence in Galicia, Spain: report of the last 26-years. J Spinal Cord Med. 2019;42(4):423-9.
  • 2. Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325-43.
  • 3. Pang D, Wilberger JE. Spinal cord injury without radiographic abnormalities in children. J Neurosurg. 1982;57(1):114-29.
  • 4. Yucesoy K, Yuksel KZ. SCIWORA in MRI era. Clin Neurol Neurosurg. 2008;110(5):429-33.
  • 5. Choi J-U, Hoffman HJ, Hendrick EB, Humphreys RP, Keith WS. Traumatic infarction of the spinal cord in children. J Neurosurg. 1986;65(5):608-10.
  • 6. Hamilton MG, Myles ST. Pediatric spinal injury: review of 61 deaths. J Neurosurg. 1992;77(5):705-8.
  • 7. Parent S, Mac-Thiong J-M, Roy-Beaudry M, Sosa JF, Labelle H. Spinal cord injury in the pediatric population: a systematic review of the literature. J Neurotrauma. 2011;28(8):1515-24.
  • 8. Brauge D, Plas B, Vinchon M, et al. Multicenter study of 37 pediatric patients with SCIWORA or other spinal cord injury without associated bone lesion. Orthop Traumatol Surg Res. 2020;106(1):167-71.
  • 9. Erhan B, Ulu MO, Gunduz B, Tanriverdi T. Pediatric spine and spinal cord injury in Istanbul: a retrospective analysis of 106 patients. Neurosurg Q. 2005;15(1):21-4.
  • 10. Kim C, Vassilyadi M, Forbes JK, Moroz NW, Camacho A, Moroz PJ. Traumatic spinal injuries in children at a single level 1 pediatric trauma centre: report of a 23-year experience. Can J Surg. 2016;59(3):205.
  • 11. Rush JK, Kelly DM, Astur N, et al. Associated injuries in children and adolescents with spinal trauma. J Pediatr Orthop. 2013;33(4):393-7.
  • 12. Mistry D, Munjal H, Ellika S, Chaturvedi A. Pediatric spine trauma: A comprehensive review. Clin Imaging. 2022.
  • 13. Dogan S, Safavi-Abbasi S, Theodore N, et al. Thoracolumbar and sacral spinal injuries in children and adolescents: a review of 89 cases. J Neurosurg: Pediatrics. 2007;106(6):426-33.
  • 14. Jarvers J-S, Herren C, Jung MK, et al. Pediatric cervical spine injuries—results of the German multicenter CHILDSPINE study. Eur Spine J. 2023:1-9.
  • 15. Atesok K, Tanaka N, O’Brien A, et al. Posttraumatic spinal cord injury without radiographic abnormality. Adv Orthop. 2018;2018.
  • 16. Donenberg JG, Fetters L, Johnson R. The effects of locomotor training in children with spinal cord injury: a systematic review. Dev Neurorehabil. 2019;22(4):272-87.
  • 17. Vogel LC, Lubicky JP. Ambulation in children and adolescents with spinal cord injuries. J Pediatr Orthop. 1995;15(4):510-6.
  • 18. Powell A, Davidson L. Pediatric spinal cord injury: a review by organ system. Phys Med Rehabil Clin N Am. 2015;26(1):109-32.
  • 19. Merenda L, Park Brown J. Bladder and bowel management for the child with spinal cord dysfunction. J Spinal Cord Med. 2004;27(sup1):S16-S23.
  • 20. Garcia-Arguello LY, O'Horo JC, Farrell A, et al. Infections in the spinal cord-injured population: a systematic review. Spinal Cord. 2017;55(6):526-34.
  • 21. Li F, Song M, Xu L, Deng B, Zhu S, Li X. Risk factors for catheter‐associated urinary tract infection among hospitalized patients: A systematic review and meta‐analysis of observational studies. J Adv Nurs. 2019;75(3):517-27.
  • 22. Mitchell BG, Prael G, Curryer C, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control. 2021;49(8):1058-65.
  • 23. Vogel L, Anderson C. Spinal cord injuries in children and adolescents: a review. J Spinal Cord Med. 2003;26(3):193-203.
  • 24. McCarthy J, Chafetz R, Betz R, Gaughan J. Incidence and Degree Of Hip Subluxation/Dislocation In Children With Spinal Cord Injury. J Spinal Cord Med. 2004;27(sup1):S80-S3.
  • 25. Maynard FM. Immobilization hypercalcemia following spinal cord injury. Arch Phys Med Rehabil. 1986;67(1):41-4.
  • 26. Jones T, Ugalde V, Franks P, Zhou H, White RH. Venous thromboembolism after spinal cord injury: incidence, time course, and associated risk factors in 16,240 adults and children. Arch Phys Med Rehabil. 2005;86(12):2240-7.
  • 27. Kim J, Lee JY, Lee E. Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. J Nurs Manag. 2022;30(5):O1-O9.
  • 28. Jaja BN, Jiang F, Badhiwala JH, et al. Association of pneumonia, wound infection, and sepsis with clinical outcomes after acute traumatic spinal cord injury. J Neurotrauma. 2019;36(21):3044-50.
  • 29. D’Hondt F, Everaert K. Urinary tract infections in patients with spinal cord injuries. Current infectious disease reports. 2011;13(6):544-51.
  • 30. Henke AM, Billington ZJ, Gater Jr DR. Autonomic dysfunction and management after spinal cord injury: a narrative review. J Pers Med. 2022;12(7):1110.
  • 31. Unsal-Delialioglu S, Kaya K, Sahin-Onat S, Kulakli F, Culha C, Ozel S. Fever during rehabilitation in patients with traumatic spinal cord injury: analysis of 392 cases from a national rehabilitation hospital in Turkey. J Spinal Cord Med. 2010;33(3):243-8.
  • 32. Yıldız N, Akkoç Y, Erhan B, et al. Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up. Spinal Cord. 2014;52(6):462-7.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Zerrin Kasap 0000-0001-7584-4716

Canan Çelik 0000-0002-9838-5329

Elif Begüm Kılıç 0000-0002-5069-0631

Özge Tezen 0000-0003-2934-0423

Yayımlanma Tarihi 18 Aralık 2023
Gönderilme Tarihi 22 Aralık 2022
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

Vancouver Kasap Z, Çelik C, Kılıç EB, Tezen Ö. PEDİATRİK POPÜLASYONDA TRAVMATİK SPİNAL KORD YARALANMASI REHABİLİTASYONUNUN DEĞERLENDİRİLMESİ. ETD. 2023;62(4):542-8.

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