Clinical Audit Determining Standard of Care for Musculoskeletal Health in Children With Spinal Cord Disorders
Abstract
BACKGROUND: Pediatric spinal cord disorders (SCD) are rare and devastating. However, evidence on the effect on musculoskeletal health management is limited.
OBJECTIVES: To investigate the relationships between SCD characteristics and musculoskeletal complications in children with SCD.
METHODS: Medical records of patients admitted between January 2010 and December 2022 with SCD were retrospectively reviewed. Demographic data and the presence of hypercalcemia, fractures, scoliosis, hip dysplasia, spasticity, contractures, calcium, and vitamin D status were obtained (N = 100; male, 61%; median [IQR] age at diagnosis, 9 [9.5] years, range 0-17).
RESULTS: Traumatic diagnoses represented 36% of patients. Incidence of scoliosis was 41%, hip dysplasia 12%, pathological fractures 9%, spasticity 32%, contractures 27%, hypercalcemia 20%, and vitamin D insufficiency 28% of total. Hypercalcemia was associated with male patients (odds ratio [OR] 4.07, 95% CI 1.03-16.06) and wheelchair users (OR 6.77, 95% CI 1.99-23.84). Nonambulant subjects were at increased risk of having scoliosis (OR 11.69, 95% CI 3.04-44.96), hip dysplasia (OR 55.64, 95% CI 5.59-553.41), contractures (OR 10.72, 95% CI 2.64-43.53), spasticity (OR 3.19, 95% CI 1.14-8.87), and presence of three or more musculoskeletal-related complications (OR 27.03, 95% CI 5.62-130.10).
CONCLUSION: Children with SCD are susceptible to many complications related to musculoskeletal health. This research provides comprehensive data on both…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 100 participants or records.
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