While there are many potential causes of SCI, some are more common than others in pediatrics. As previously mentioned, iatrogenic SCI is the result of surgical or medical treatment by a physician (Krishnan & Kasthuri 2005). According to DeVivo and Vogel (2004), surgical complications account for a significantly greater proportion of SCIs in adolescents (13 – 21 years of age) than in adults. In addition, as suggested by Smith et al. (2017), iatrogenic causes are only second to transport incidents in causing traumatic SCI in teenagers. While SCI caused by spinal deformity surgery is uncommon in the pediatric population, it is well documented. It is a rare complication after lower extremity surgery in children with skeletal dysplasia and thoracic kyphosis (Pruszczynski et al. 2015).
The mid-thoracic spinal cord is most vulnerable to vascular injury (Youlo et al. 2013). With vascular insults to the spinal cord being documented as a cause for SCI, injuries above the level of instrumentation are rare. In some instances, chest compressions needed to resuscitate an unconscious person may lead to unintended SCI. Samson et al. (2012) described one such case in which a 4-month-old male experienced an episode of asystole and left ventricle fibrillation following a heart transplant. This episode led to the child undergoing 10 minutes of chest compressions. The child was later found to be a paraplegic with radiological imaging showing he had experienced subdural hematoma and hemorrhagic medullary contusion from T4 – T10 with subarachnoid hemorrhaging from T10 – S2. While instances such as this do occur in children, they are relatively rare. Although there are some documented cases of medical treatment leading to SCI, more information on potential causes and severity is needed to fully understand iatrogenic SCI in children.