Paediatrics Head and Spine Trauma Treatment Cost in India

Head and Spine trauma in pediatrics refers to injury or accident that affects the brain and/or spine. This can be treated by means of a minimally invasive surgery to repair the injury using state-of-art techniques. However, surgery is done with only those with severe cases. 

With Spinal cord injury, surgery is performed to stabilize fractured bones, evaluate the injured bone, decompress pressure from the injured area, and manage any other injuries. Unfortunately, there is no cure to repair bruised or damaged spinal cord. 

Children are prone to head injuries as the anatomical structure of their head is relatively larger in size than their trunk. Only a small portion of injury is found to have Traumatic Brain Injury (TBC).

Recommended: What is head and spine trauma?

Causes of Head and Spine Trauma

In small babies, trauma could be caused by abuse like violent shaking or jolting of the head. In older children, it could be many factors like:

• Sports-related injury
• Accidents like falls
• Motorcrash
• Or any other reason like being hit on the head. 

Symptoms of Head and Spine Trauma

Symptoms vary on the nature and severity of the injury. Symptoms may also occur immediately or hours later. Some common symptoms are:

• Nausea
• Vomiting
• Headache
• Seizures 
• Confusion
• Blurred vision
• Loss of consciousness
• Loss of movement or sensation
• Imbalance 
• Pain
• No control of bowel or bladder
• Pressure in the back, neck or, head
• Difficulty to breath
• Loss of bowel and bladder function.

You may be interested in: Symptoms of Spinal Cord Injury

Classification of head trauma

This is done based on the Glasgow Coma Scale to evaluate level of consciousness consisting of parameters on eye opening, best verbal response, and best motor response. The Paediatric GCS is found to be particularly useful for pre-verbal children. The classifications are:

GCS 14 to15: minor head trauma
GCS 9 to 13: moderate head trauma
GCS < 8: severe head trauma

For a spinal cord injury, classification is made based on mild, severe, or fatal.

Diagnostic tests

• Physical exam
• Neurological exam
• Blood tests
• CT Scan
• MRI Scan
• X-Ray
• EEG

Indications for a surgery:

• Skull fractures that are both open and depressed
• When the fractured piece is greater than or equal to 5mm
• Underlying bleeding
• Dural tear
• Significant contamination

Procedure

Before Procedure

• Thorough physical examination of your child
• Considering the age of the child for surgery
• Perform diagnostic tests
• Review of your child’s overall health and medical history
• Your child will be asked to stop eating certain medications if he is currently taking any
• Your child will be made to fast 8 – 12 hours before the surgery
• If any medication is given, it should be swallowed with small sips of water.

During Procedure

• Your child will be given general anaesthesia so that no pain will be felt during the surgery and your child will be asleep
• The child’s brain and muscles will be monitored throughout the surgery
• An incision is made on the area of fracture which is like an “S” or “U” shape
• For forehead depression, a bi-coronal incision is preferred
• Bony fragments are raised and an inspection is made if there is any tear on the dural
• A repair is made if there is a dural tear
• Bony fragments are soaked in anti-biotic solution or isotonic sodium chloride solution and a reassembling is done
• Titanium may be used to wire the larger bone pieces together
• The incision is closed
• Dressing will be applied to the affected area.

After Procedure

• Your child will experience some pain and discomfort which will eventually fade away
• Pain medications may also be administered depending on the child’s age and development 
• A close follow-up of the skull may be done for children with dural tear due to the possibility of the skull fracture expanding
• To check abscess formation, frequent tests and checks will be done in the next 2 – 3 months
• Follow-up is also dependent on the complications associated with the fractures
• Your child may need rehabilitative management like physical, occupational, or speech therapy
• Your child may need a breathing equipment called a ventilator if there was a spinal injury
• Recovering from spinal cord injury require a long-term hospital stay and rehabilitation
• Ensuring a safe atmosphere for the child to heal and play again

Helpful: Diagnosis of Head & Spine Injuries

Risks and complications

Every surgery is not without risks and complications. Certain factors that could affect the child are:

• Excessive bleeding
• Infections
• Blot clots
• Allergy to anaesthesia
• Nerve damage
• Depending on the severity, the child could lose part/s of muscles, speech, vision, hearing, or taste
• Temporary or permanent change in behavior or personality could occur
• May need life lifelong actions 

Cost and factors affecting the cost of the surgery

Certain factors that affect cost include:

• Choice of hospital
• Location of the hospital
• Duration of hospital stay
• Surgeon’s fee
• Cost for blood tests and diagnostic tests
• Medical care
• Duration of hospital stay