Incomplete spinal cord injuries

Incomplete spinal cord injury (SCI) in children refers to partial damage to the spinal cord that allows for some preservation of motor or sensory function below the level of injury. Unlike complete spinal cord injuries, where there is total loss of function, incomplete injuries vary widely in severity and prognosis. With timely diagnosis, neurosurgical intervention, and rehabilitation, many children can recover significant neurological function and lead independent lives. In Bangladesh, the burden of pediatric spinal trauma is increasing due to a rise in accidents, falls, and birth-related injuries. Awareness, early imaging, and the availability of pediatric neurosurgical expertise—led by specialists like Dr. Md. Nafaur Rahman—are essential for improving outcomes in such cases. Common Causes of Incomplete Spinal Cord Injury in Children (Bangladesh Context) Road Traffic Accidents (RTAs): Children riding motorcycles or crossing roads are particularly vulnerable Falls from rooftops or stairwells: Common in both rural and urban homes with poor structural safety Birth Trauma: Especially during difficult or forceful deliveries Sports Injuries: Football, cricket, gymnastics, or diving into shallow water Child Abuse or Non-Accidental Trauma: Though rare, can lead to serious spinal damage Infections or Tumors compressing the spinal cord Congenital spine deformities or tethered cord that progress over time Types of Incomplete Spinal Cord Injuries Pediatric incomplete SCIs are classified based on the pattern of neurological loss: Anterior Cord Syndrome Loss of motor function and pain/temperature sensation Preservation of position and vibration sense Central Cord Syndrome Greater weakness in upper limbs than lower limbs Often results from hyperextension injuries Brown-Séquard Syndrome Paralysis on one side of the body (ipsilateral) Loss of pain and temperature on the opposite side (contralateral) Posterior Cord Syndrome Loss of position and vibration sense Preservation of motor function Each of these syndromes has different implications for prognosis and treatment planning. Clinical Features Children with incomplete SCI may present with: Partial paralysis (hemiparesis, monoparesis, or paraparesis) Sensory deficits (tingling, numbness, loss of vibration or pain) Spasticity or muscle stiffness Bladder and bowel dysfunction Gait abnormalities or difficulty standing/walking Scoliosis or spinal deformity (developing over time) Diagnostic Evaluation Timely and accurate diagnosis is essential for favorable outcomes: MRI Spine: Critical for evaluating spinal cord edema, hemorrhage, or compression CT Scan: Identifies fractures or dislocations X-rays: Useful in emergency settings Neurological Examination: Assess motor, sensory, and reflex activity Somatosensory and Motor Evoked Potentials: Evaluate neural pathway integrity Urodynamic Studies: Assess bladder dysfunction in chronic cases Treatment and Surgical Management by Dr. Md. Nafaur Rahman Dr. Md. Nafaur Rahman brings years of specialized experience in managing pediatric spinal trauma using both surgical and non-surgical approaches. Non-Surgical Management Steroid therapy (select cases): To reduce inflammation Spinal bracing or orthotics for stabilization Bladder/bowel management programs Comprehensive neuro-rehabilitation Family counseling and psychological support Surgical Management Surgery may be necessary in cases of: Persistent spinal cord compression from bone fragments, tumor, or infection Spinal instability or vertebral dislocation Congenital spinal anomalies with neurological deterioration Progressive scoliosis or deformity from SCI Surgical options include: Spinal decompression (laminectomy, corpectomy) Spinal stabilization and instrumentation (using rods, screws, and plates) Correction of spinal alignment CSF diversion if hydrocephalus develops Rehabilitation and Recovery The recovery process for children with incomplete spinal cord injury is more promising than in complete injuries. A multidisciplinary rehabilitation plan includes: Physiotherapy: Muscle re-education, balance, and strength training Occupational Therapy: Skills for daily living and independence Speech and Swallow Therapy (in high cervical injuries) School reintegration and social adaptation programs Early rehabilitation maximizes neurological recovery and prevents complications such as contractures, pressure ulcers, and psychosocial challenges. Long-Term Monitoring and Prognosis Although many children show improvement, close monitoring is necessary to detect: Progressive scoliosis Neurogenic bladder and kidney complications Chronic pain or neuropathy Spasticity and movement disorders The prognosis depends on the severity, level of injury, and timing of intervention. With expert care by Dr. Md. Nafaur Rahman, many children regain near-normal function or significant independence. Why Choose Dr. Md. Nafaur Rahman for Pediatric Spinal Care? One of the most experienced pediatric spinal neurosurgeons in Bangladesh Expert in complex spinal decompression and reconstruction surgeries Holistic care through a multidisciplinary team approach Based at the National Institute of Neurosciences & Hospital (NINS) Child-friendly, compassionate environment at Bangladesh Paediatric Neurocare Centre Contact Information 📌 Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Appointment or Emergency Consultation: 📱 +8801912988182 | +8801607033535 🌐 Visit: www.neurosurgeonnafaur.com