Spinal cord injury without radiographic abnormality

Spinal cord injury without radiographic abnormality
Other namesSpinal cord injury without computed tomography evidence of trauma (SCIWOCTET)[1]
SpecialtyEmergency medicine, neurosurgery
SymptomsNumbness, weakness, abnormal reflexes, loss of bladder or bowel control, neck pain[2][3]
DurationShort or long term[3]
CausesMotor vehicle collision, falls, sports injuries[3]
Diagnostic methodBased on symptoms, medical imaging[2]
TreatmentConservative, rigid cervical collar, surgery[2]
Prognosis~2% risk of death[2]
FrequencyRare[2]

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.[4][5] Symptoms may include numbness, weakness, abnormal reflexes, or loss of bladder or bowel control.[2] Neck or back pain is also common.[3] Symptoms may be brief or persistent.[3] Some do not develop symptoms until a few days after the injury.[3]

Causes may include motor vehicle collisions, falls, sports injuries, and non accidental trauma.[3][2] 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.[3] Magnetic resonance imaging (MRI) is recommended to determine if further problems are present.[2]

Treatment is often based on the MRI findings and whether or not symptoms are persistent.[2] If the MRI is normal and symptoms have resolved no or brief neck bracing may be recommended.[2] Otherwise a rigid cervical collar or surgery to immobilize the neck for three months is recommended.[2] If the MRI is abnormal surgery to hold the neck still may be carried out [2] Typically people should avoid further high risk activities for the next six months.[3] The use of corticosteroids is not generally recommended.[2]

The condition is rare.[2] Most cases are believed to occur in children and the elderly.[4] Males are more frequently affected than females.[3][2] Outcomes are generally good if the MRI is normal but less so if problems are found.[2] The risk of death is low at about 2%.[2] It was first defined in 1982.[2]

  1. ^ Cite error: The named reference Mar2017 was invoked but never defined (see the help page).
  2. ^ a b c d e f g h i j k l m n o p q r Farrell CA, Hannon M, Lee LK (June 2017). "Pediatric spinal cord injury without radiographic abnormality in the era of advanced imaging". Current Opinion in Pediatrics. 29 (3): 286–290. doi:10.1097/MOP.0000000000000481. PMID 28306628. S2CID 3515237.
  3. ^ a b c d e f g h i j Knadmin (May 4, 2017). "Spinal cord injury without radiological abnormality". PM&R KnowledgeNow. Retrieved 30 May 2018.
  4. ^ a b Peitzman A, Rhodes M, Schwab CW, Yealy DM, Fabian TC (2012). The Trauma Manual: Trauma and Acute Care Surgery. Lippincott Williams & Wilkins. pp. 288–289. ISBN 978-1-4511-1679-3.
  5. ^ Szwedowski D, Walecki J (2014). "Spinal Cord Injury without Radiographic Abnormality (SCIWORA) - Clinical and Radiological Aspects". Polish Journal of Radiology. 79: 461–4. doi:10.12659/PJR.890944. PMC 4262055. PMID 25505497.