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Journal Article

Citation

Achildi O, Betz RR, Grewal H. J. Spinal Cord Med. 2007; 30: S21-4.

Affiliation

Section of Pediatric Surgery, Department of Surgery, Temple University School of Medicine and Temple University Children's Medical Center, Philadelphia, Pennsylvania 19140, USA.

Copyright

(Copyright © 2007, Academy of Spinal Cord Injury Professionals, Publisher Maney Publishing)

DOI

unavailable

PMID

17874682

PMCID

PMC2031975

Abstract

BACKGROUND/OBJECTIVE: Approximately 250,000 patients are presently living with spinal cord injury (SCI) in the United States. Approximately 20% of patients with SCI are less than 20 years old, and 15% are less than 15 years old. The most common cause of pediatric SCI is a motor vehicle collision (MVC; approximately 40%); lapbelt injuries and the seatbelt syndrome are seen more often in children involved in MVCs. METHODS: A search and analysis of current literature on lapbelt injuries, seatbelt syndrome, and pediatric SCI using PubMed. RESULTS: Children involved in MVCs who are improperly restrained are at higher risk of sustaining injuries. The risk of significant intra-abdominal injuries is increased almost fourfold in these children. Presence of abdominal wall ecchymosis (AWE) was associated with intra-abdominal injuries in up to 84% of children, with hollow viscus injury being the most common. Likewise, presence of AWE is associated with vertebral fractures, including Chance fractures, in up to 50% of patients. Vertebral fractures were associated with SCI in up to 11%. The presence of AWE in an improperly restrained child should warrant a thorough search for intra-abdominal injuries, vertebral fractures, and SCI. CONCLUSIONS: Lapbelt injuries and the seatbelt syndrome are often associated with pediatric SCI in improperly restrained children. This injury complex and its associated abdominal injuries are difficult to diagnose unless a high index of suspicion is maintained; delay in diagnosis increases morbidity, and early surgical intervention should be considered.


Language: en

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