Complications of Therapies for Thoracolumbar Spine Trauma in Children

  • Higher rate in complete injury: The rate of complications is increased in complete spinal cord injuries.
  • Common complications: These include infection and sacral decubitus ulcers because of lack of mobilization and bowel/bladder incontinence.
  • Deformity: Progressive deformity can occur in spinal cord injury patients, especially in those injured prior to adolescent growth spurt. Bracing may be necessary to prevent or delay surgery in growing children with history of spinal cord injury (21).
  • Back pain: Up to 1/3 of patients complain of occasional back pain after spine injury (14,23).
  • Syringomyelia: Syringomyelia may develop and consideration of obtaining MRI should be given to patients with progressive neurologic deficits with history of spinal cord injury (4).

Surgical

  • Infection: Superficial wound infection may be treated with antibiotics. However, deep infection may necessitate irrigation and debridement of the wound, with subsequent long-term antibiotic treatment (and in rare cases, removal of hardware).
  • Pseudarthrosis: If solid body arthrodesis is not achieved, patients can complain of pain at levels that have not fused. This failure of fusion can also lead to hardware loosening and failure.
  • Hardware failure: Without long-term bony arthrodesis, instrumentation can loosen and fracture. This can lead to increased pain or deformity and may necessitate revision and/or extension of the hardware and fusion.