Turkish Journal of Physical Medicine and Rehabilitation 2004 , Vol 50 , Num 3

Çocukta Vertebra Kırığı veya Dislokasyon Olmaksızın Gelişen Spinal Kord Yaralanması

Ernur Ergöz 1 ,Semra Aktuğ 2 ,Nurdan Kotevoğlu 3 ,Banu KURAN 4
1 Isparta Gülkent Devlet Hastanesi, Isparta
2 Şişli Etfal Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
3 Şişli Etfal Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği
4 Clinic of Physical Medicine and Rehabilitation, Şişli Etfal Training and Research Hospital, İstanbul, Turkey

Spinal cord injury without radiographic abnormality (SCIWORA) characterized by the absence of radiological findings is frequently seen in children. Juvenile  spine with its increased hipermobility and unique anatomy differs from adult  spine.  Injury is often seen at cervical and thorasic regions.  A 9-year-old girl presenting with complete paraplegia below T10 (on the right side) and T9 (on the left side) after a traffic accident was admitted to the Department of Orthopedics and Traumatology. She was diagnosed as SCIWORA by magnetic resonance imaging (MRI). Following high dose corticosteroid treatment she was referred to the Department of Physical Medicine and Rehabilitation. Inpatient rehabilitation involved strengthening of the upper extremities along with trunk and postural control. At discharge, she had achieved therapeutic ambulation by knee-ankle-foot orthosis with a pelvic band. Following necessary adjustments, she could attend her school and continue her education. In order to diagnose even minor injuries causing oedema, politraumatized children with spinal cord injury should be screened by imaging techniques like MRI. Rehabilitation intervention should focus on the improvement of functional skills for independence in daily living activities.

Keywords : Child, spinal cord injuries, SCIWORA