![]() Some authors used the term spinal cord injury without radiographic evidence of trauma (SCIWORET) to describe these cases. ![]() Historical literature regarding spinal cord concussion, spinal cord contusion and hyperextension/hyperflexion injuries to the spine describe similar cases to modern cases of SCIWORA.Īfter the introduction of SCIWORA, the term was expanded to adults presenting with degenerative changes. īefore 1982, the phenomenon of clinics-radiological mismatch was known as well. The most common cause is being hit by a vehicle while on foot. In older people, spondylosis or problems with blood vessels can cause SCIWORA. SCI in adults could be due to instability of vertebral ligaments or a herniation of a disk or a hematoma around the spinal cord that presses on it-none of which would show up on X-rays. In particular, adults often present with degenerative changes of the spinal column resulting in predisposing spinal stenosis. There seem to be relevant differences between pediatric and adult SCIWORA. Later, a similar condition was reported in adults. The acronym SCIWORA was coined by Pang and Wilderer in 1982 This first description on spinal cord injuries with clinics-radiological mismatch was followed by a large number of case reports and case series. Boese and Lechler proposed an MRI-based classification for SCIWORA which correlated with the neurological outcome: Type 1Įxtraneural and intraneural abnormalities. Recently, systematic reviews on SCIWORA described the clinical and radiological patterns and correlations with neurological outcome. The application of MRI plays a significant role in the early diagnosis and treatment of SCIWORA in children and adults. The prognostic value of intra- and extra-medullary MRI findings is subject of ongoing research in the field of SCIWORA. Overall, there seems to be a relation between extent of damage to the spinal cord and the clinical prognosis. A full recovery can be achieved without treatment within minutes to hours and permanent injuries might prevail. This phenomenon was primarily seen in children but was reported in adults as well. Notably, the clinical symptoms can present with a delay of hours to days after the trauma. It is present in a significant number of children with SCI. SCIWORA may present as a complete spinal cord injury (total loss of sensation and function below the lesion) or incomplete spinal cord injury (some sensation and/or function is preserved). Outcomes are generally good if the MRI is normal but less so if problems are found. Males are more frequently affected than females. Most cases are believed to occur in children and the elderly. The use of corticosteroids is not generally recommended. If the MRI is abnormal surgery to hold the neck still may be carried out Typically people should avoid further high risk activities for the next six months. Otherwise a rigid cervical collar or surgery to immobilize the neck for three months is recommended. If the MRI is normal and symptoms have resolved no or brief neck bracing may be recommended. Treatment is often based on the MRI findings and whether or not symptoms are persistent. Magnetic resonance imaging (MRI) is recommended to determine if further problems are present. A number of underlying mechanisms are proposed including spinal cord contusion, injury to the blood supply to the spinal cord, and excessive stretching of the cord. Ĭauses may include motor vehicle collisions, falls, sports injuries, and non accidental trauma. Some do not develop symptoms until a few days after the injury. Symptoms may include numbness, weakness, abnormal reflexes, or loss of bladder or bowel control. Spinal cord injury without radiographic abnormality ( SCIWORA) is symptoms of a spinal cord injury (SCI) with no evidence of injury to the spinal column on X-rays or CT scan. ![]() Motor vehicle collision, falls, sports injuries Ĭonservative, rigid cervical collar, surgery Numbness, weakness, abnormal reflexes, loss of bladder or bowel control, neck pain Spinal cord injury without computed tomography evidence of trauma (SCIWOCTET) Medical condition Spinal cord injury without radiographic abnormality ![]()
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