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Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal

Received: 14 February 2021    Accepted: 24 February 2021    Published: 7 April 2021
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Abstract

Introduction: Spinal trauma in children is rare, accounting for 1 and 10% of all spinal traumas. They constitute an entity in their own right due to the injuries they cause. Difficulties (diagnostic) and modalities (therapeutic), different from those of adults the growth of children. The lack of studies in Sub-Saharan Africa leads us to carry out this study focused on the traumatic spine of the child. Patients and Methods: Over a period of 8 and a half years from January 2012 to June 2020, we retrospectively studied 44 cases involving 4 Senegalese hospitals, 3 of which were in the capital and 1 in the province, including children up to the age of 16 who had suffered spinal trauma. Results: Forty-four children were retained, a frequency of 7.11%, with an average age of 10.5 years; sex ratio: 1.6. The most frequent aetiologies were: falls (from trees, from buildings): 41%; play accidents and accidents on public roads: 20.4% each. The average consultation time was 31.3 days. 34% of the patients were ASIA E patients. The majority of patients had performed a spine CT scan as an imaging examination, i.e. 95.4%. The most common site of injury was cervical with 61.3%. The most frequent lesions were: fractures, fracture-luxations and dislocations with 27.3%, 25% and 25% respectively. Five patients had associated lesions, i.e. 11.3% (4 head traumas, 9.1% and 1 pelvic trauma, 1.9). Most of the treatment was surgical (43% orthopaedic, 38.6%) and functional (16%). The post-therapy neurological evaluation (ASIA - backward step) was: A: 25%; B: 2.3%; C: 7%; D: 13.7%; E: 52.3%. We noted 3 deaths and 4 patients were re-operated. There were no consolidation complications such as pseudoarthrosis. Conclusion: Trauma to the spine in children, like any bone trauma, responds well to orthopaedic treatment. Deaths are often related to upper cervical spine injuries or occur in the context of polytrauma. Follow-up should be carried out over several years to detect possible complications at an early stage. Delays in treatment due to the difficulties of punctual medicalised transport remain the challenge to be met in our environment.

Published in International Journal of Neurosurgery (Volume 5, Issue 1)
DOI 10.11648/j.ijn.20210501.14
Page(s) 13-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Children, Spine, Trauma, Senegal

References
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[2] Ferey S, Kalifa G, Cohen PA, Adamsbaum C. Imaging of pediatric spine injury. J Radiol 2005; 86: 263-72.
[3] Hardley MN, Zabramski JM, Browner CM, Rekate H, Sonntag VK. Pediatric spinal trauma: review of 122 cases of spinal cord and vertebral column injury. Journal of Neurosurgery, 68, 18-24, 1988.
[4] Parent S, Mac-Thiong JM, Roy-Beaudry M, Sosa JF, Labelle H. Spinal cord injury in the pediatric population: A systematic review of literature. Journal of neurotrauma 2011; 28: 1515-24.
[5] Vitale MG, Goss JM, Matsumoto H, Roye DP. Epidemiology of pediatric spinal cord injury in the United States. Journal pediatrortop 2006; 26: 745-9.
[6] Bilston LE, Brown J. Pediatric spinal injury: Type and severity are age andmechanism dependent. Spine 2007; 21: 2339-47.
[7] Muzumdar D, Ventureyra EC. Spinal cord injuries in children. Pediatric Neuroscience Journal 2006; 1: 43-8.
[8] Hamilton MG, Mylks ST. Pediatric spinal injury: review of 174 hospital admissions. Journal of Neurosurgery. 1992; 77 (5): 700-704.
[9] Carreon LY, Glassman SD, Campbell MJ. Pediatric spine fractures: Review of 137 hospital admissions. J Spinal DisordTech. 2004; 17 (6): 477-482
[10] Bansal ML, Sharawat R, Mahajan R, Dawar H, Mohapatra B, Das K, et al. Spinal injury in Indian children: review of 204 cases. Global Spine J. 2019. DOI: 10.1177/2192568219887155.
[11] Turgut M, Akpinar G, Akalan N, Özcan OE. Spinal injuries in the pediatric age group: a review of 82 cases of spinal cord and vertebral columm injuries. European Spine Journal 5 (3): 148-152. (1996) DOI: 10.1007/BF00395505.
[12] Sane JC, Hope JMV, Souleymane D, Kassé AN, Diouf JD, Nikiema AN et al. (2018) Epidemiology of Traumatic Spinal Injury: A 15-Year. Retrospective Study of 1092 Cases. Journal of Spine 7: 429. DOI: 10.4172/2165-7939.1000429.
[13] Katar S, Ozturk P. A, Ozel M, Cevik S, Evran S, Baran O et al (2020). Pediatric Spinal Traumas. PediatrNeurosurg, 1-6. DOI: 10.1159/000508332.
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[15] Pennecot GF, Chadoutaut F, Pouliquen JC. Severe trauma to the child's spine. Annals of surgery 35, 506-512, 1981. P 7.
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[17] Benantar L. Vertebro-medullary traumas in children. Experience of the neurosurgery department (2002-2010) of the Mohamed VI University Hospital in Marrakech. Thesis Medicine Marrakech, University Cadi AYYAD; 2012, N°36: 113 p.
[18] Gopinathan NR, Viswanathan VK, Crawford AH. Cervical spine evaluation in pediatric trauma: a review and an update of current concepts. Indian J Orthop. 2018; 52 (5): 489-500. DOI: 10.4103/ortho.IJOrtho_607_17.
[19] Viccellio P, Simon H, Pressman BD, Shah MN, Mower WR, Hoffman JR et al A prospective multicenter study of cervical spine injury in children. Pediatrics. 2001; 108 (2): E20. DOI: 10.1542/peds.108.2.e20.
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    Faye Mohameth, Adolphe Bimangou, Mualaba Celebre, El Hadji Cheikh Ndiaye Sy, Diop Abdoulaye, et al. (2021). Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal. International Journal of Neurosurgery, 5(1), 13-18. https://doi.org/10.11648/j.ijn.20210501.14

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    Faye Mohameth; Adolphe Bimangou; Mualaba Celebre; El Hadji Cheikh Ndiaye Sy; Diop Abdoulaye, et al. Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal. Int. J. Neurosurg. 2021, 5(1), 13-18. doi: 10.11648/j.ijn.20210501.14

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    AMA Style

    Faye Mohameth, Adolphe Bimangou, Mualaba Celebre, El Hadji Cheikh Ndiaye Sy, Diop Abdoulaye, et al. Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal. Int J Neurosurg. 2021;5(1):13-18. doi: 10.11648/j.ijn.20210501.14

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  • @article{10.11648/j.ijn.20210501.14,
      author = {Faye Mohameth and Adolphe Bimangou and Mualaba Celebre and El Hadji Cheikh Ndiaye Sy and Diop Abdoulaye and Barry Lounceny Fatoumata and Mhaks Malangu and Ba Momar Code},
      title = {Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal},
      journal = {International Journal of Neurosurgery},
      volume = {5},
      number = {1},
      pages = {13-18},
      doi = {10.11648/j.ijn.20210501.14},
      url = {https://doi.org/10.11648/j.ijn.20210501.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20210501.14},
      abstract = {Introduction: Spinal trauma in children is rare, accounting for 1 and 10% of all spinal traumas. They constitute an entity in their own right due to the injuries they cause. Difficulties (diagnostic) and modalities (therapeutic), different from those of adults the growth of children. The lack of studies in Sub-Saharan Africa leads us to carry out this study focused on the traumatic spine of the child. Patients and Methods: Over a period of 8 and a half years from January 2012 to June 2020, we retrospectively studied 44 cases involving 4 Senegalese hospitals, 3 of which were in the capital and 1 in the province, including children up to the age of 16 who had suffered spinal trauma. Results: Forty-four children were retained, a frequency of 7.11%, with an average age of 10.5 years; sex ratio: 1.6. The most frequent aetiologies were: falls (from trees, from buildings): 41%; play accidents and accidents on public roads: 20.4% each. The average consultation time was 31.3 days. 34% of the patients were ASIA E patients. The majority of patients had performed a spine CT scan as an imaging examination, i.e. 95.4%. The most common site of injury was cervical with 61.3%. The most frequent lesions were: fractures, fracture-luxations and dislocations with 27.3%, 25% and 25% respectively. Five patients had associated lesions, i.e. 11.3% (4 head traumas, 9.1% and 1 pelvic trauma, 1.9). Most of the treatment was surgical (43% orthopaedic, 38.6%) and functional (16%). The post-therapy neurological evaluation (ASIA - backward step) was: A: 25%; B: 2.3%; C: 7%; D: 13.7%; E: 52.3%. We noted 3 deaths and 4 patients were re-operated. There were no consolidation complications such as pseudoarthrosis. Conclusion: Trauma to the spine in children, like any bone trauma, responds well to orthopaedic treatment. Deaths are often related to upper cervical spine injuries or occur in the context of polytrauma. Follow-up should be carried out over several years to detect possible complications at an early stage. Delays in treatment due to the difficulties of punctual medicalised transport remain the challenge to be met in our environment.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal
    AU  - Faye Mohameth
    AU  - Adolphe Bimangou
    AU  - Mualaba Celebre
    AU  - El Hadji Cheikh Ndiaye Sy
    AU  - Diop Abdoulaye
    AU  - Barry Lounceny Fatoumata
    AU  - Mhaks Malangu
    AU  - Ba Momar Code
    Y1  - 2021/04/07
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijn.20210501.14
    DO  - 10.11648/j.ijn.20210501.14
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 13
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20210501.14
    AB  - Introduction: Spinal trauma in children is rare, accounting for 1 and 10% of all spinal traumas. They constitute an entity in their own right due to the injuries they cause. Difficulties (diagnostic) and modalities (therapeutic), different from those of adults the growth of children. The lack of studies in Sub-Saharan Africa leads us to carry out this study focused on the traumatic spine of the child. Patients and Methods: Over a period of 8 and a half years from January 2012 to June 2020, we retrospectively studied 44 cases involving 4 Senegalese hospitals, 3 of which were in the capital and 1 in the province, including children up to the age of 16 who had suffered spinal trauma. Results: Forty-four children were retained, a frequency of 7.11%, with an average age of 10.5 years; sex ratio: 1.6. The most frequent aetiologies were: falls (from trees, from buildings): 41%; play accidents and accidents on public roads: 20.4% each. The average consultation time was 31.3 days. 34% of the patients were ASIA E patients. The majority of patients had performed a spine CT scan as an imaging examination, i.e. 95.4%. The most common site of injury was cervical with 61.3%. The most frequent lesions were: fractures, fracture-luxations and dislocations with 27.3%, 25% and 25% respectively. Five patients had associated lesions, i.e. 11.3% (4 head traumas, 9.1% and 1 pelvic trauma, 1.9). Most of the treatment was surgical (43% orthopaedic, 38.6%) and functional (16%). The post-therapy neurological evaluation (ASIA - backward step) was: A: 25%; B: 2.3%; C: 7%; D: 13.7%; E: 52.3%. We noted 3 deaths and 4 patients were re-operated. There were no consolidation complications such as pseudoarthrosis. Conclusion: Trauma to the spine in children, like any bone trauma, responds well to orthopaedic treatment. Deaths are often related to upper cervical spine injuries or occur in the context of polytrauma. Follow-up should be carried out over several years to detect possible complications at an early stage. Delays in treatment due to the difficulties of punctual medicalised transport remain the challenge to be met in our environment.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Unit, Assane Seck University, Ziguinchor, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Neurosurgery Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal

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