Progressive treatment options for children with spinal cord injury.

The purpose of this article is to describe new and innovative treatment options that can enhance function for the pediatric patient with a spinal cord injury (SCI). There are several studies that have demonstrated that functional electrical stimulation (FES) can be beneficial to children and adolescents with SCI. In most instances, FES for hand function has been able to increase independence and decrease the need for caretaker assistance and adaptive equipment. Likewise, lower extremity applications of FES have reduced the amount of bracing required for stepping and have restored autonomy and spontaneity to children. Children and adults alike have gained bladder and bowel continence from FES systems. Other progressive options that are relatively new for children are muscle and tendon transfers to restore function and increase independence with various activities of daily living such as eating and grooming. In addition, although available for some time for children with congenital anomalies, urinary diversion procedures allow children with SCI to catheterize themselves, thereby affording them renewed independence. All of these innovations have the potential to improve the quality of life (QOL) for children and adolescents with SCI.