Spinal Cord Trauma

Since the spinal cord is still developing in children, it’s important to diagnose and treat any type of trauma that may be affecting how nerves transmit signals from the bladder to the brain as soon as possible.

Spinal cord trauma can result in an injury that’s considered “complete” or “incomplete.” With a complete spinal cord injury, there is no sensation or motor functions below the affected area. If the SCI is in the mid- or lower back area, the urinary system may be affected. Even with an incomplete injury where there is still some motor or sensory function below the affected part of the spine, a child may experience the following issues:

• Urinary incontinence (UI)
• Related problems involving bowel control
• An inability to completely empty the bladder (incomplete voiding or urinary retention)

• If spinal cord trauma resulted in extreme pressure being placed on the bladder, a child may have an increased risk of developing kidney-related problems. This is also true if the bladder is no longer able to properly remove urine from the body.
• As a precaution, a pediatric urologist typically monitors children with a contracted bladder caused by some type of SCT to make sure both kidneys are functioning normally.

With trauma to the spinal cord that’s considered mild, a pediatric urologist may recommend “watchful waiting” to see if urinary functions improve once inflammation from the trauma goes away. If a child is unable to fully empty their bladder, temporary use of a catheter including intermittent catheterization may be necessary to reduce the risk of urinary tract infections and kidney problems. Treatment for children with SCT trauma affecting bladder/bowel functions may also involve:

• Medication to help with bladder muscle control
• Surgery to divert the urine (temporarily or permanently) if the bladder does not function properly
• Surgery to relieve pressure on affected nerves and stabilize the affected area to help maintain bladder/bowel control