Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 3
Disclosures: Alyssa B. Zuziak, DO: Nothing to disclose
Case Description: At a routine pediatric physiatry office visit about 2 years after his injury, the patient complained of neuropathic pain in his feet and gluteal area, areas which were previously insensate. He had changes in his bowel habits, but also had a history of bowel program noncompliance. There was no change in bladder function. His physical exam revealed increased tone in lower extremities. A full spine MRI revealed new cord edema between C3 and C5, likely representing pre-syrinx changes in addition to holocord syrinx formation between T1 and the level of the conus at L1 to L2. By the time he was seen by neurosurgery 2 weeks later, he had developed difficulty self-propelling his wheelchair and new arm/upper back pain. He underwent surgery shortly thereafter where a thoracic syringopleural shunt was placed.
Setting: Tertiary-care pediatric hospital
Patient: 7-year-old male with presumed C6 ASIA-B injury following motor vehicle accident.
Assessment/Results: Since surgery, he has started to regain some function of his hands and his neuropathic pain has decreased, though is still present. His bowel function is improved, but there has also been better adherence to a bowel regimen. He still has increased tone in his lower extremities that remains unchanged. He is due to undergo postoperative imaging in the next few weeks.
Discussion: Little is known regarding post-pediatric spinal cord injury complication rates or the timeline in which they develop after injury. It is interesting this patient developed neuropathic pain in an area that was previously insensate and bowel changes, yet bladder function remained unchanged. The imaging obtained was his first imaging since his injury, as there are no guidelines on when or if to obtain post-injury imaging in children.
Conclusion: Further research into post-injury complications following pediatric spinal cord injuries needs to be obtained to better understand complications children may experience and when they may occur.
Level of Evidence: Level V
To cite this abstract in AMA style:Zuziak AB, Shieh E. Post-traumatic Syrinx Formation Following Pediatric Spinal Cord Injury: A Case Report [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/post-traumatic-syrinx-formation-following-pediatric-spinal-cord-injury-a-case-report/. Accessed December 9, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/post-traumatic-syrinx-formation-following-pediatric-spinal-cord-injury-a-case-report/