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There are many ways you can help children and their families get the care they need.
Like the injuries themselves, the treatment options for SCIs are very specific to the individual child. Your child's treatment team will develop a customized care plan according to:
• the type and location of spinal cord injury your child has sustained
• the extent of the injury
• the extent of complications your child is experiencing
• your child's age, overall health and medical history
• your child's tolerance for particular medications, procedures or therapies
• your family's preferences for treatment
A known or suspected spinal cord injury requires emergency medical attention at the scene.
While you or other bystanders are waiting for emergency personnel, it's imperative to keep your child's head and neck immobilized. Although the impulse to cradle and comfort the child, or to move him to a different position or place, is understandable, it is essential that he not be moved by anyone other than trained medical personnel.
Any SCI calls for a period of hospitalization, ranging from weeks to several months. Your child will most likely be admitted to the Intensive Care Unit (ICU), where a multidisciplinary team of clinicians will observe him, evaluate his progress and attend to all of his medical needs while helping you plan for the future.
Here at Boston Children's, your child's treatment team will include some or all of the following:
• neurological and neurosurgical professionals
• orthopedic professionals
• trauma and emergency medicine professionals
• pain treatment professionals
• nurses who specialize in SCIs
• respiratory professionals
• physical therapists
• occupational therapists
• psychologists and social workers
All members of the team will work closely together, and will include you and your family in every aspect of the treatment process.
While no surgical procedure can reverse or otherwise “fix” a spinal cord injury, surgery can sometimes be beneficial by allowing doctors to:
• stabilize any spinal fractures
• releasing pressure on the spinal cord
• treating any other injuries that occurred at the same time as the SCI
Some medications can be helpful in:
• reducing swelling around the spinal cord injury
• controlling pain
• managing spasticity (involuntary muscle contractions)
• improving bowel and bladder control
Children whose spinal cord injuries affect their arm and/or leg function benefit greatly from wheelchairs. A wheelchair can make great strides possible in day-to-day living, travel, socialization and even sports!
Children who have sustained a spinal cord injury in the neck area may lose some or all ability to breathe on their own. They may need a machine called a ventilator, which takes over breathing functions by pumping oxygen into the child's lungs and clearing out carbon dioxide.
Some SCIs can cause a temporary or permanent loss of bowel and bladder control. Urodynamic studies may be performed after the injury to measure how easily the child can empty his bladder (if at all).
There are several tools that can help a child manage incontinence, including Foley catheters, tubes placed into the bladder to drain urine. Once the child's condition stabilizes, catheterization can be done on a periodic basis to make sure his bladder is emptied while lessening the risk of an infection.
Children's has a dedicated Center for Continence of Urine and Bowel (CUB) to assist with incontinence issues tied to a wide range of medical conditions.
A child with a severe SCI that compromises his neck and throat muscles may have difficulty chewing and swallowing, putting him at risk for nutritional insufficiency.
A feeding tube—which is threaded from the nostrils down to the stomach, or directly into the abdomen to reach the stomach—is an effective way of ensuring the child consumes sufficient calories.
Physical therapy and other rehabilitation services are essential for any child with a spinal cord injury. The rehabilitation team will create a plan for your child that focuses on:
• preventing muscle wasting
• reducing spasticity
• retraining the child to use other muscles that help with mobility and movement
Spinal cord injuries are often lifelong conditions for a child—and involve lifelong challenges for the entire family.
As difficult as coping with a serious SCI can be, it's important to remember that there is cause for hope: Regardless of the severity of your child's SCI, there are ways to maximize his capabilities at home, at school and in the community.
Positive reinforcement from you and other family members, combined with professional support services, will help your child strengthen his self-esteem and gain the greatest possible level of independence.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”