Clinical Audit Determining Standard of Care for Musculoskeletal Health in Children With Spinal Cord Disorders.

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 traumatic and nontraumatic SCD disease etiologies in Victoria, Australia.