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Orthogate
1089 Spadina Road
Toronto, AL M5N 2M7
Ph: 416-483-2654
Fax: 416-483-2654
christian@orthogate.com






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Child Orthopedics
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Our 11-year-old granddaughter was in a car accident and has a broken spine. There is real concern that she has damage to the spinal cord that could leave her paralyzed. We're looking for any information that could help us guide her parents through this difficult time.

Spinal cord injuries in children are rare but when they do happen, there is understandably grave concern for them. Most of the children affected are in their teens (15 and older). Only 10 per cent of all pediatric spinal cord injuries affect children younger than 15. All of that is to say there isn't a lot of evidence to guide treatment. Much of what is done is based on how adults are treated. Fortunately, children seem to respond well (often better than adults). The first goal of treatment is to stabilize the spine. There is a concern that fractures and broken pieces of the spinal bone could cut into the spinal cord. Dislocated vertebrae can alter the size and shape of the spinal canal (opening for the spinal cord). Anything that changes the dimensions of the spinal canal can put pressure on the spinal cord. Treatment is designed to realign the spine and prevent compression of the nerve tissue. Sometimes this can be accomplished without surgery. But much more often, surgery is done to realign the bones and hold them in place until healing occurs. Taking pressure off the spinal cord is referred to as a decompression procedure. Using wires, screws, metal plates, or rods to hold the spine in place is referred to as internal fixation or instrumentation. After the spine is stabilized, everyone on the team (parents or family, physicians, physical therapists, nurses) monitors the child closely for the first sign of scoliosis (spinal curvature) or other spinal deformity. Bracing right away is strongly encouraged to keep the curve from getting worse and perhaps prevent the need for spinal fusion. When bracing doesn't prevent worsening of the deformity, then surgery may be needed to fuse the spine and hold it in place. The health care and rehabilitation team caring for your granddaughter will walk the family through each step and each decision required. Your steady support will be a tremendous help to all who are involved.

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