Author/Authors :
Theiss, Steven Department of Orthopaedic Surgery - University of Alabama at Birmingham - Birmingham - AL, USA , Atesok, Kivanc Department of Orthopaedic Surgery - University of Alabama at Birmingham - Birmingham - AL, USA , Deinlein, Donald Department of Orthopaedic Surgery - University of Alabama at Birmingham - Birmingham - AL, USA , Pittman, Jason Department of Orthopaedic Surgery - University of Alabama at Birmingham - Birmingham - AL, USA , Manoharan, Sakthivel Rajaram Department of Orthopaedic Surgery - University of Alabama at Birmingham - Birmingham - AL, USA , Tanaka, Nobuhiro Department of Orthopaedic Surgery - Hiroshima University - Hiroshima, Japan , O’Brien, Andrew Royal Victoria Hospital and Royal Belfast Hospital for Sick Children - Belfast, UK , Robinson, Yohan Department of Surgical Sciences - UppsalaUniversityHospital - Uppsala, Sweden , Pang, Dachling Department of Pediatric Neurosurgery - University of California - Davis - CA, USA
Abstract :
Spinal Cord Injury without Radiographic Abnormality” (SCIWORA) is a term that denotes objective clinical signs of posttraumaticspinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine.SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of thecervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can alsobe seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too. Magnetic resonance imaging (MRI) hasbecome a valuable diagnostic tool in patients with SCIWORA because of its superior ability to identify soft tissue lesions such ascord edema, hematomas and transections, and discoligamentous injuries that may not be visualized in plain radiographs and CT.The mainstay of treatment in patients with SCIWORA is nonoperative management including steroid therapy, immobilization, andavoidance of activities that may increase the risk of exacerbation or recurrent injury. Although the role of operative treatment inSCIWORA can be controversial, surgical alternatives such as decompression and fusion should be considered in selected patientswith clinical and MRI evidence of persistent spinal cord compression and instability
Keywords :
Posttraumatic Spinal Cord Injury , Radiographic Abnormality , SCIWORA , Spinal Cord Injury without Radiographic Abnormality
