| Spinal cord injury without radiographic abnormality | |
|---|---|
| Other names | Spinal cord injury without computed tomography evidence of trauma (SCIWOCTET) [1] |
| File:PMC3318880 jocmr-01-165-g007 (1).png | |
| a) T2W saggital MR image of male shows cord contusion at C6-7 level and disc bulging at C3-4 and C6-7 levels b) T2W saggital MR image after one year, focal myelomalacia at C6-7 level. | |
| Specialty | Emergency medicine, neurosurgery |
| Symptoms | Numbness, weakness, abnormal reflexes, loss of bladder or bowel control, neck pain [2] [3] |
| Duration | Short or long term [3] |
| Causes | Motor vehicle collision, falls, sports injuries [3] |
| Diagnostic method | Based on symptoms, medical imaging [2] |
| Treatment | Conservative, rigid cervical collar, surgery [2] |
| Prognosis | ~2% risk of death [2] |
| Frequency | Rare [2] |
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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]
SCIWORA 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]
References
- ^ Martinez-Perez, R; Munarriz, PM; Paredes, I; Cotrina, J; Lagares, A (March 2017). "Cervical Spinal Cord Injury without Computed Tomography Evidence of Trauma in Adults: Magnetic Resonance Imaging Prognostic Factors". World Neurosurgery. 99: 192–199. doi: 10.1016/j.wneu.2016.12.005. PMID 27979630.
- ^ 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.
- ^ a b c d e f g h i j "Spinal cord injury without radiological abnormality". PM&R KnowledgeNow. May 4, 2017. Archived from the original on 2 March 2021. Retrieved 30 May 2018.
- ^ a b Peitzman, A.B.; Rhodes, M.; Schwab, C. W.; Yealy, Donald M.; Fabian, Timothy C. (2012). The Trauma Manual: Trauma and Acute Care Surgery. Lippincott Williams & Wilkins. pp. 288–289. ISBN 978-1-4511-1679-3. Archived from the original on 2018-06-12. Retrieved 2018-05-30.
- ^ 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.
| Spinal cord injury without radiographic abnormality | |
|---|---|
| Other names | Spinal cord injury without computed tomography evidence of trauma (SCIWOCTET) [1] |
| File:PMC3318880 jocmr-01-165-g007 (1).png | |
| a) T2W saggital MR image of male shows cord contusion at C6-7 level and disc bulging at C3-4 and C6-7 levels b) T2W saggital MR image after one year, focal myelomalacia at C6-7 level. | |
| Specialty | Emergency medicine, neurosurgery |
| Symptoms | Numbness, weakness, abnormal reflexes, loss of bladder or bowel control, neck pain [2] [3] |
| Duration | Short or long term [3] |
| Causes | Motor vehicle collision, falls, sports injuries [3] |
| Diagnostic method | Based on symptoms, medical imaging [2] |
| Treatment | Conservative, rigid cervical collar, surgery [2] |
| Prognosis | ~2% risk of death [2] |
| Frequency | Rare [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]
SCIWORA 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]
References
- ^ Martinez-Perez, R; Munarriz, PM; Paredes, I; Cotrina, J; Lagares, A (March 2017). "Cervical Spinal Cord Injury without Computed Tomography Evidence of Trauma in Adults: Magnetic Resonance Imaging Prognostic Factors". World Neurosurgery. 99: 192–199. doi: 10.1016/j.wneu.2016.12.005. PMID 27979630.
- ^ 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.
- ^ a b c d e f g h i j "Spinal cord injury without radiological abnormality". PM&R KnowledgeNow. May 4, 2017. Archived from the original on 2 March 2021. Retrieved 30 May 2018.
- ^ a b Peitzman, A.B.; Rhodes, M.; Schwab, C. W.; Yealy, Donald M.; Fabian, Timothy C. (2012). The Trauma Manual: Trauma and Acute Care Surgery. Lippincott Williams & Wilkins. pp. 288–289. ISBN 978-1-4511-1679-3. Archived from the original on 2018-06-12. Retrieved 2018-05-30.
- ^ 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.