Musculoskeletal changes and treatments in paediatric spinal cord disorders: A scoping review

Purpose: This study aimed to highlight the structural and functional musculoskeletal changes and associated treatment strategies in paediatric patients with spinal cord disorders (SCD). Methods: A systematic scoping review was conducted whereby PubMed, Excerpta Medica Database and MEDLINE Ovid databases, and grey literature were searched for articles published between January 2000 and June 2024. Study criteria included at least 50% of participant cohort being children aged under 18 years at time of SCD diagnosis, investigating the musculoskeletal effects of SCD in children, and related management or interventional strategies. Reports in which paediatric or SCD participants were less than 50% of the cohort were included if results were appropriately stratified. Included reports underwent descriptive analysis. Results: Forty-five reports were eligible for inclusion. Physiological Parameters, Musculoskeletal Complications, and Interventions were the main themes identified. It was observed that musculoskeletal changes following SCD can differ in children compared to their adult-injured counterparts, but the mechanisms underlying these differences are not known. Intervention studies that have been performed are important, but underpowered, and cannot yet be translated into routine care. Conclusion: Monitoring and treatment guidelines for musculoskeletal health in this population are scarce. Comprehensive research efforts are required to facilitate guideline development, which will be imperative in improving musculoskeletal outcomes following paediatric SCD.