Conditions & Treatments
- A to Z Guide

Spinal cord injury

Disease Information

Treatment & Care

What are the treatment options for a child with a spinal cord injury?
Like the injuries themselves, the treatment options for SCIs are very specific to the individual child. Your child's treatment team will develop a customized care plan according to:

the type and location of spinal cord injury your child has sustained
the extent of the injury
the extent of complications your child is experiencing
your child's age, overall health and medical history
your child's tolerance for particular medications, procedures or therapies
your family’s preferences for treatment

Prior to treatment: Immobilizing the head and neck at the time of the injury

A known or suspected spinal cord injury requires emergency medical attention at the scene.

While you or other bystanders are waiting for emergency personnel, it’s imperative to keep your child’s head and neck immobilized. Although the impulse to cradle and comfort the child, or to move him to a different position or place, is understandable, it is essential that he not be moved by anyone other than trained medical personnel.

Hospitalization and observation

Any SCI calls for a period of hospitalization, ranging from weeks to several months. Your child will most likely be admitted to the Intensive Care Unit (ICU), where a multidisciplinary team of clinicians will observe him, evaluate his progress and attend to all of his medical needs while helping you plan for the future.

Here at Children’s, your child’s treatment team will include some or all of the following:

neurological and neurosurgical professionals
orthopedic professionals
trauma and emergency medicine professionals
pain treatment professionals
nurses who specialize in SCIs
respiratory professionals
physical therapists
occupational therapists
psychologists and social workers

All members of the team will work closely together, and will include you and your family in every aspect of the treatment process.

Surgery

While no surgical procedure can reverse or otherwise “fix” a spinal cord injury, surgery can sometimes be beneficial by allowing doctors to:

stabilize any spinal fractures
releasing pressure on the spinal cord
treating any other injuries that occurred at the same time as the SCI

Medication

Some medications can be helpful in:

reducing swelling around the spinal cord injury
controlling pain
managing spasticity (involuntary muscle contractions)
improving bowel and bladder control

Wheelchairs and other mobility assistance devices

Children whose spinal cord injuries affect their arm and/or leg function benefit greatly from wheelchairs. A wheelchair can make great strides possible in day-to-day living, travel, socialization and even sports!

Breathing support

Children who have sustained a spinal cord injury in the neck area may lose some or all ability to breathe on their own. They may need a machine called a ventilator, which takes over breathing functions by pumping oxygen into the child’s lungs and clearing out carbon dioxide.

Bowel and bladder support

Some SCIs can cause a temporary or permanent loss of bowel and bladder control. Urodynamic studies may be performed after the injury to measure how easily the child can empty his bladder (if at all).

There are several tools that can help a child manage incontinence, including Foley catheters, tubes placed into the bladder to drain urine. Once the child’s condition stabilizes, catheterization can be done on a periodic basis to make sure his bladder is emptied while lessening the risk of an infection.

Children’s has a dedicated Center for Continence of Urine and Bowel (CUB) to assist with incontinence issues tied to a wide range of medical conditions.

Feeding support

A child with a severe SCI that compromises his neck and throat muscles may have difficulty chewing and swallowing, putting him at risk for nutritional insufficiency.

A feeding tube—which is threaded from the nostrils down to the stomach, or directly into the abdomen to reach the stomach—is an effective way of ensuring the child consumes sufficient calories.

Rehabilitation

Physical therapy and other rehabilitation services are essential for any child with a spinal cord injury. The rehabilitation team will create a plan for your child that focuses on:

preventing muscle wasting
reducing spasticity
retraining the child to use other muscles that help with mobility and movement

Lifelong considerations for children with spinal cord injuries

Spinal cord injuries are often lifelong conditions for a child—and involve lifelong challenges for the entire family.

As difficult as coping with a serious SCI can be, it’s important to remember that there is cause for hope: Regardless of the severity of your child’s SCI, there are ways to maximize his capabilities at home, at school and in the community.

Positive reinforcement from you and other family members, combined with professional support services, will help your child strengthen his self-esteem and gain the greatest possible level of independence.

Neuromotor Therapy Program
Children who experienced a brain or spinal cord injury very early in life can have a variety of problems with their ability to move, and their needs change frequently as they get older. The Neuromotor Therapy Program at Children’s Hospital Boston is devoted to maximizing the motor skills of these children. Learn more.

Coping and support

When your child has a spinal cord injury, your family is grappling with many concerns and questions. Not only are you focused on meeting all of your child’s medical needs; you are also facing a significant emotional and psychological toll that can affect every member of the family.

In addition to the clinical information offered on this page, Children’s has several other resources designed to give your family comfort, support and guidance:

Patient and family resources at Children’s

Children’s Center for Continence of Urine and Bowel (CUB) brings together experts in gastroenterology, general surgery, neurosurgery and urology to help children of all ages with bladder and bowel incontinence.
Our Neuromotor Therapy Program is devoted to assisting children with spinal cord injuries and other traumatic neurological injuries maximize their motor skills.
Children’s Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital—as well as their families—understand and cope with their feelings about:
being sick
facing uncomfortable procedures
handling pain
taking medication
preparing for surgery
changes in friendships and family relationships
managing school while dealing with an illness
grief and loss
Children’s Psychiatry Consultation Service is comprised of expert and compassionate pediatric psychologists, psychiatrists, social workers and other mental health professionals who understand the unique circumstances of hospitalized children and their families. The team provides several services, including:
short-term therapy for children admitted to one of our inpatient units
parent and sibling consultations
teaching healthy coping skills for the whole family
educating members of the medical treatment team about the relationship between physical illness and psychological distress
The Experience Journal was designed byChildren’s psychiatrist-in-chief David DeMaso, MD and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers about living with medical conditions and going through treatment.
Children’s Department of Psychiatry publishes a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide”(.pdf file). Topics in the booklet include:
talking to your child about her condition
preparing for surgery and hospitalization
supporting siblings
taking care of yourself during your child’s illness
adjusting to life after treatment
Children’s Center for Families is dedicated to helping families locate the information and resources they need to better understand their child’s particular condition and take part in their care. All patients, families and health professionals are welcome to use the Center’s services at no extra cost. The center is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
The Children’s chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child’s treatment.
Children's International Center is a dedicated resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at 01-617-355-5209 or via e-mail at international.center@childrens.harvard.edu.

Helpful links

Please note that neither Children’s Hospital Boston nor the Spinal Program at Children's unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.