"How are the kids?" the chiropractor asked.
"Oh they're fine," Mrs. Jones replied, "they don't have any problems."
In this situation, it is hard to imagine that a rear end collision which could cause significant problems for Mrs. Jones would have caused no problems at all for her children.
Children passengers who are involved in auto accidents frequently suffer injuries without showing any overt symptoms. This fact is often overlooked after an auto accident, simply because the child does not complain of pain symptoms or because an infant or toddler is unable to communicate their symptoms to their parents. Symptoms such as irritability, lethargy, poor feeding and restlessness may be the only evidence that a young infant has suffered injuries. In older children who are better able to communicate, symptoms may include fatigue, headache, neck pain or restricted range-of-motion.
Injuries suffered in an auto accident can cause spinal problems in children which may not be evident for months or, in some cases, years after the incident. But worse than this, children may have suffered significant spinal injuries which need immediate attention, but which remain quite hidden due to the inability of children to communicate their symptoms. A thorough and careful evaluation of each child involved in an auto accident is essential to detect spinal problems which can have long-term consequences to their health.
Chiropractors frequently treat adult patients for the late effects of injuries suffered in an auto accident some months earlier. It is not unusual for headache symptoms to occur many months after an accident. In such cases, the patient will frequently report having only minor neck soreness for a couple of days following the accident. The problem here is that the muscle and ligament injuries to the neck can cause changes in the normal spinal curves, resulting in spinal degeneration.
The need for a detailed and thorough examination of the spine of all children involved in auto accidents is well documented in the pediatric literature. Because children have greater flexibility in their necks, they are more likely to suffer from spinal cord damage than they are to have fractures of the spinal vertebrae. This fact is due to the different rates of stretch between the spinal column, which is comprised of the vertebrae, muscles and ligaments, and the spinal cord which carries all important nerve impulses to and from the brain. The spinal column has been shown experimentally to have up to two inches of stretch before vertebral or ligament damage occurs, whereas the spinal cord which resides inside the spinal column has only a one-half inch of stretch before hemorrhage can occur. As a result of this difference in the rate of stretch between these two structures, young children are more likely to suffer spinal cord and nerve damage than they are to fracture vertebrae or injure the ligament structures which hold the spinal vertebrae together.
As a result of this potential for children to suffer spinal injuries without any apparent symptoms, it is important that all children involved in auto accidents, no matter how minor, should receive a detailed and thorough spinal examination to ensure that these problems have been excluded. Such an examination must include a detailed and thorough examination of the child's nervous system to rule out any possible spinal cord damage.
The neurological component of this examination requires evaluation of cranial and peripheral nerves, for motor and sensory deficits. In very young infants, evaluation of the primitive reflexes also will provide additional information of the status of the nervous system.
As a spinal specialist, the chiropractor is trained to provide an accurate and thorough examination of the spine and nervous system and to evaluate if an infant or child has suffered any injuries as a result of an auto accident. The danger in parents ignoring this possibility can lead either to short-term effects on their health or to long-term problems with premature spinal degeneration, or both. The long-term costs of ignoring the need for a child's spinal examination can be significant and may destine the child to a future neck pain, stiffness, spinal instability, headaches and other associated neurological problems.
Peter Fysh, DC
San Jose, California
Editor's Note:
Dr. Fysh is currently conducting pediatric seminars. He may be contacted at (408) 944-6000.
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