Management and outcomes of traumatic pediatric spinal cord injuries in low- and middle-income countries: A scoping review

Abstract

Background: Traumatic spinal cord injury (TSCI) is a subset of neurotrauma, which is a significant contributor to global trauma mortality and morbidity in children. The management and outcomes of pediatric TSCI in low- and middle-income countries (LMICs) is unknown. We conducted a scoping review to characterize the methods of management and outcomes of TSCI in LMICs. Methods: MEDLINE, Embase, and Global Index Medicus were searched from database inception to February 15, 2021. Studies reporting management or outcomes of pediatric TSCI in LMICs were included. Pooled statistics were calculated using measures of central tendency and spread. Results: A total of 1171 studies were identified, of which 5 were included. A total of 212 patients were included in our review with age of participants ranging from 2.5 to 18 years (mean, 15.4 years). Most patients were male (n = 162; 76.4%). The commonest cited cause of injury were falls (n = 104/212; 49.1%). The most common level of injury was cervical (n = 83; 39.2%). Most patients underwent surgery (n = 134/212; 63.2%). The extent of injury was quantified and classified using the American Spinal Injury Association chart in only 1 study. Long-term management data were not present in any of the included studies. Conclusions: There is a scarcity of studies reporting the management and outcome of pediatric TSCI in LMICs. The paucity of studies in this domain provides insufficient data to be compared, reducing the ability to draw a strong conclusion. This situation hinders the development of guidelines to inform best practice.