The mortality rate of spine-related trauma in children is higher than in adults and is estimated at 25% to 32%. Fortunately, children with incomplete neurologic lesions fare better than adults, with up to 90% having partial recovery and 60% having…
Vascular lesions of the spine are uncommon in children. Vascular lesions are subdivided into fast-flow lesions, such as arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs), and slow-flow lesions, such as venous (formerly “cavernous”) malformations. Rarely, children suffer spinal cord infarcts.…
Spinal Neoplasms Overview. Spinal tumors occur predominantly in young or middle-aged adults and are rare in children. The most common presentation is vague pain, gait disturbance, change in spinal curvature, motor weakness, and bowel and bladder dysfunction. In this chapter,…
Spinal infections in children occur uncommonly. Etiologies include direct and indirect (hematogenous) inoculation by bacterial, viral, parasitic, and fungal agents. Direct bacterial infectious inoculation may be as a result of trauma, instrumentation, or via a preexisting congenital sinus tract or…
Embryology and Developmental Anatomy Spine formation begins early in gestation, commencing at the end of the second gestational week with formation of the Hensen node and continuing into the beginning of the third week with the appearance of the neural…
Vast improvements have been made in the diagnosis and therapy of fetal anomalies as a result of advances in imaging and surgical technology. Nowhere is this more applicable than in the fetal spine. Ultrasonography is the primary imaging modality for…
Pediatric spinal cord imaging relies heavily on ultrasound (US) in infants under 6 months of age and magnetic resonance imaging (MRI) thereafter. Other imaging modalities, such as radiography, computed tomography (CT), and nuclear scintigraphy, have a limited role but may…
Embryology The spinal cord forms in three stages beginning in the third gestational week. The first stage, neurulation, involves progression from neural plate to neural tube. The notochord becomes the nucleus pulposus of the intervertebral disks. The second stage, canalization,…
Incidence and Etiology Head trauma and resulting traumatic brain injury (TBI) are among the most common causes of morbidity and mortality in children. Head trauma alone is responsible for 50% of deaths in children ages 1 to 14 years. Approximately…
Overview Epilepsy is a common pediatric neurologic disorder. In North America, the overall incidence of epilepsy is approximately 50/100,000 per year, highest for children below 5 years of age and the elderly. Children are at higher risk for developing epilepsy…