Spinal-cord injuries during birth.

The subject of perinatal injury to the spinal cord is briefly reviewed. Recognized causative factors are traction on the infant's trunk during breech delivery, rotational stresses applied to the spinal axis, traction on the cord via the brachial plexus in shoulder dystocia, and hyperextension of the fetal head in breech delivery or transverse presentation. Recognition of these factors is the basis for prevention of this terrible accident. Diagnostic criteria at various period of life are mentioned and the importance of the recognition of anaesthesia and reflex movements is emphasized. Treatment is mainly supportive. The development of an automatic reflex bladder evacuation is discussed. Follwup examinations and resourceful orthopedic care are essential. A few affected children learn to live with their disability and a very few who are apparently transected at birth recover surprisingly well.