Elevated Systemic Inflammatory Mediators In Pediatric Traumatic Spinal Cord Injury
Naomi-Liza Denning1, Ibrahim Abd el-shafy2, Adrianna Vlachos1, Debra J Morrison3, *Jose M Prince1, Ona E Bloom3
1Cohen Children's Medical Center at Northwell Health, New Hyde Park, NY;2Maimonides Medical Center, Brooklyn, NY;3Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY
Background (issue): Pediatric traumatic spinal cord injury (SCI) is a rare but devastating injury occurring in approximately 1300 children in the US annually. In adults with SCI, inflammation is present acutely and persists chronically, where it is thought to increase secondary damage, inhibit neurological recovery and promote medical consequences. In children, there is a paucity of data regarding the inflammatory response to SCI. This lack of knowledge limits development of therapeutic strategies to promote recovery. Here, we report a pilot study measuring systemic inflammation in children with traumatic SCI.
Methods:Traumatic SCI patients were prospectively identified at an ACS-accredited Level 1 pediatric trauma center. Demographic and clinical information were recorded. C-reactive protein (CRP) and interleukin 6 (IL-6) levels were measured from discarded clinical serum samples obtained from SCI patients and a group of age/gender matched healthy controls (N=4).
Findings:Five patients (80% male) with cervical, thoracic, or lumbar SCI were identified from November 2016-April 2019. The average age was 14.2 (7.3-17.8) years. Mechanisms of injury were: sports accident, falls, pedestrian struck, and falling debris. CRP levels in SCI patients tended to be elevated compared to healthy controls (8.4 ± 6.6 mg/L vs 1.4 ± 2.7 mg/L, p = 0.08). IL-6 levels were also increased. (15.3 ± 19.4 pg/mL vs undetectable, p=0.16). The three patients with the highest CRP levels required surgical intervention.
Conclusions (implications for practice):Systemic inflammatory mediators were elevated in traumatic pediatric SCI. Higher CRP levels appeared to correlate with need for surgical intervention in this pilot study. Future studies are needed with larger numbers of patients to validate these findings.
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