Birth-related spinal cord injuries:: a multicentric review of nine cases

Objective The objective of this study was to report a multicentric study of nine cases of children presenting with a birth-related spinal injury. Materials and methods The medical charts of nine patients identified by a questionnaire sent to the members of the French Society of Paediatric Orthopaedics (SOFOP) were reviewed. Conclusions The pregnancy was uneventful in all cases. The fetal presentation was cephalic in three cases, a breech presentation in four cases, a face presentation in two cases. The lesion involved the cervical spine in six cases. Three patients presenting upper cervical injuries died before the age of 6 years. The six remaining patients experienced no neurological improvement. These rare conditions occur during difficult deliveries with abnormal presentations, the most common being a breech presentation with entrapment of the fetal head. In a child with hypotonia, flaccid quadriplegia or high thoracic paraplegia after a difficult delivery, a spinal cord injury must be suspected and plain radiographs and magnetic resonance imaging (MRI) must be performed.