Pediatric Spinal Disorders

Pediatric spinal disorders are relatively rare, but typically manifest in one of several more common presentations. Although most disorders involve congenital malformations that may be diagnosed even at birth, acquired defects may also occur, as well as defects that develop over the course of various associated syndromes.

CONDITIONS EXPLAINEDPediatric Spinal Disorders

CONDITIONS EXPLAINEDPediatric Spinal Disorders

Pediatric spinal disorders are relatively rare, but typically manifest in one of several more common presentations. Although most disorders involve congenital malformations that may be diagnosed even at birth, acquired defects may also occur, as well as defects that develop over the course of various associated syndromes.

Some of the more common pediatric presentations include:

  • Chiari Malformation Types I and II – These malformations are characterized by herniation of the cerebellar tonsils downward through the foramen magnum of the skull. Usually not life threatening, but often symptomatic with headaches and cerebellar effects.
  • Spina Bifida (Aperta, Oculta) – Failure of spinal cord to fuse completely.
  • Lipomeningocele – Neural tube defect associated with accumulation of fat tissue near the spinal cord.
  • Myelomeningocele – Congenital extrusion of spinal cord tissue through the vertebrae, a potentially life threatening condition.
  • Scoliosis – Abnormal curvature of the spine.
  • Split Cord Malformation – Congenital splitting of the spinal cord into two hemisections.
  • Tethered Cord – A condition in which the spinal cord is “stuck” somewhere along its route through the spinal canal.
  • Syringomyelia – A fluid-filled cyst develops in the spinal cord, and causes neurological symptoms associated with the level of the defect.
  • Spinal Cord Tumors – Abnormal growths of the spinal cord and associated tissues which may cause neurological symptoms. Examples include meningiomas and neurofibromas. Tumors can be further divided into primary and secondary forms, depending on whether the tumor originated from the spinal tissues or metastasized from a primary site elsewhere in the body.
https://mdashishpatel.com/wp-content/uploads/2021/03/what-is-a-pediactric-spinal-disorder.jpg

Pediatric spinal disorders are relatively rare, but typically manifest in one of several more common presentations. Although most disorders involve congenital malformations that may be diagnosed even at birth, acquired defects may also occur, as well as defects that develop over the course of various associated syndromes.

Some of the more common pediatric presentations include:

  1. Chiari Malformation Types I and II – These malformations are characterized by herniation of the cerebellar tonsils downward through the foramen magnum of the skull. Usually not life threatening, but often symptomatic with headaches and cerebellar effects.
  2. Spina Bifida (Aperta, Oculta) – Failure of spinal cord to fuse completely.
  3. Lipomeningocele – Neural tube defect associated with accumulation of fat tissue near the spinal cord.
  4. Myelomeningocele – Congenital extrusion of spinal cord tissue through the vertebrae, a potentially life threatening condition.
  5. Scoliosis – Abnormal curvature of the spine.
  6. Split Cord Malformation – Congenital splitting of the spinal cord into two hemisections.
  7. Tethered Cord – A condition in which the spinal cord is “stuck” somewhere along its route through the spinal canal.
  8. Syringomyelia – A fluid-filled cyst develops in the spinal cord, and causes neurological symptoms associated with the level of the defect.
  9. Spinal Cord Tumors – Abnormal growths of the spinal cord and associated tissues which may cause neurological symptoms. Examples include meningiomas and neurofibromas. Tumors can be further divided into primary and secondary forms, depending on whether the tumor originated from the spinal tissues or metastasized from a primary site elsewhere in the body.
https://mdashishpatel.com/wp-content/uploads/2021/03/what-is-a-pediactric-spinal-disorder.jpg

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Detection & Diagnosis

Pediatric spinal disorders can usually be diagnosed at birth, and will require follow up over the course of a person’s life. Some additional diagnostics can give additional insights into the nature of disease, and help physicians maximize the quality of treatment provided. Some include:

X-Ray
An effective and inexpensive option for quickly visualizing skeletal structures and isolating potential problem areas.
MRI
With or Without contrast: this is the treatment modality of choice for visualizing the soft tissues of the back such as ligaments and the intervertebral discs. Similar to CT, MRI imaging may also be enhanced with contrast.
CT Scan
With or Without Contrast: in Computed Tomography, x-rays are taken rotationally and a computer generates a three-dimensional rendering from the two-dimensional slices. This can be enhanced with contrast, called a myelogram, to further visualize the spinal cord and nerves, as well as possible tumors.

OUTCOMESRelated
Treatments & Procedures

Procedures for pediatric spinal conditions vary greatly depending on the causative agent. In some cases, surgery may be performed within days of birth to prevent complications as a child ages. In others, surgery may be held off until the child is further along in development. Left untreated, spinal defects can lead to pain and problems with urination and bowel activity.
The most common procedures performed for correction are:

  • Decompression surgery is sometimes performed to release pressure on structures affected by it, and involves directly removing certain bone structures. It is typically performed in conjunction with fusion.
  • In Fusion, the disc between vertebrae is removed and the adjacent vertebrae are grown together with bone grafts and sometimes metal hardware for support.
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Anterior Lumbar Interbody Fusion

Anterior Lumbar Interbody Fusion (ALIF) is a procedure performed from the anterior to fuse vertebrae into a single structure. This technique is usually favored when..

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Artificial Disc Replacement

Artificial disc replacement is a procedure with the goal of removing a painful intervertebral disc and replacing it with a prosthetic one. Spinal fusion is much more commonly performed..

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Decompression (Laminectomy)

Decompression Lumbar Laminectomy is the most common surgical procedure performed for the correction of stenosis in the back. The surgeon will remove or trim the bony lamina and a thick ligament..

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