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INNOSC Theranostics and
Pharmacological Sciences Spinal cord injury without radiological abnormalities

6.6. Treatment decision SCI, such as DVT, fractures, gastric ulcers, heterotopic

The treatment decision for SCIWORA in children is ossification, or syringomyelia. To prevent these
complex as it depends on various key factors, including: complications, it is advisable to use the lowest spasticity
i. Age of the child medication that is effective, ensure the patient stays warm,
[15,94]
ii. Severity of the injury and be mindful of cold weather conditions .
iii. Time of symptoms onset 6.8. Complications of SCI in children
iv. ASIA grade at the time of admission
v. Symptoms deterioration Complications resulting from SCI in younger children
vi. Patient stability and associated injuries differ from those in adolescents and adults, necessitating
vii. Presence of deformity or other spine-affecting diseases early prevention and intervention. Among younger
viii. MOI children with SCI, 96% developed scoliosis, 57% had hip
ix. Number of affected segments dysplasia, and 7% exhibited a latex allergy. In cases where
x. Presence of intradural, extradural, or both injuries were at or above the T6 level, 34% experienced
xi. Appearance of edema, hematoma, or both. autonomic dysreflexia, 41% developed pressure ulcers,
and 61% suffered from spasticity, particularly in the
6.7. Rehabilitation procedure absence of bowel or bladder control. Notably, 82% were
Rehabilitation techniques are designed to avoid secondary on intermittent catheterization, and 69% were on a bowel
effects, promote neurological recovery, and improve motor program. Additional complications include hyperhidrosis,
function. Once injury stabilization has been achieved, kidney stones, ambulation, wheelchair dependence,
the focus of rehabilitation shifts to preventing secondary lifelong growth and developmental issues, and various
complications. In SCI patients, it is crucial to consider secondary complications, such as decreased bone
the physical, neurological, emotional, and psychological density, increased risk of fracture, muscle atrophy, and
changes that arise during childhood and early adolescence. cardiovascular impairments, all of which may arise from
[29]
This holistic approach, often referred to as the “medical SCI . Complications such as pulmonary compromise,
home,” is the most important and critical factor in the pneumonia, urinary tract infection, gastrointestinal
management of SCI . The ultimate goals of recovery bleeding secondary to stress ulcers, DVT, decubitus ulcers,
[87]
are as follows: (i) Strengthening everyday independent and even the risk of death pose significant challenges in
life practices; (ii) facilitating adaptation to a new way of the treatment of children with thoracic and lumbar spinal
[95]
life through recreational activities and household events; cord lesions . Preventing DVT is helpful in reducing
and (iii) supporting reintegration into the children’s patient mortality and the risk of pulmonary embolisms.
environment . Home-based interventions during Moreover, the early elevation of the patient’s head of the
[88]
rehabilitation therapy have proven effective in promoting bed is essential to prevent various respiratory-related
the development of motor functions [89,90] . Following a SCI, complications. These complications should be viewed as
extensive practice, including over-ground practice, results risks of SCI, emphasizing the need for early prevention and
in significant recovery . In pediatric rehabilitation, intervention throughout the rehabilitation process.
[91]
numerous tools are available, but some present 6.9. Traditional Chinese medicine (TCM)
disadvantages, particularly in young children. Achieving
optimal recovery can be challenging, as it often requires TCM is an important supplementary treatment in potentially
a significant amount of space for assessment. In addition, repairing injured spinal cords. Early implementation of
item-based tasks can be time-consuming, and certain trials TCM therapy has demonstrated effectiveness in improving
[96]
may not be appropriate, especially for young children . motor function in SCI patients . Six active natural
[92]
Initiating early rehabilitation training following the compounds found in herbs commonly used in TCM
selected treatment method can help reduce the incidence exhibit anti-inflammatory and antioxidant properties.
of pressure sores, deep vein thrombosis (DVT), and other These compounds have been shown to significantly reduce
complications. This approach can also lead to a better bleeding, edema, and necrotic tissue in the damaged area .
[97]
prognosis and improved outcomes . Spasticity following Consequently, TCM can serve as an auxiliary therapy to
[93]
[98]
SCI is a motor disorder characterized by increased muscle promote functional recovery following SCI .
tone with exaggerated tendon jerks. Some medications, 6.10. Post-treatment suggestions
such as tizanidine, can cause hypotension and bradycardia,
while Clostridium botulinum works as a neuromuscular Delays in symptom presentation and the potential for
blocker. If the patient does not exhibit any changes, it is recurrence pose significant risks in SCIWORA cases, and
important to consider the secondary complications of nursing management should be vigilant in this regard . To
[99]

Volume 7 Issue 1 (2024) 6 https://doi.org/10.36922/itps.1386