(SCIWORA) Spinal Cord Injury Without Radiological Abnormality is the condition where radiological abnormalities are not detected following spinal cord injury mostly in childhood.
It can occur in 2/3rd cases of severe cervical injury in ages less 8 years old who also have the most unfavorable prognosis, which is probably associated with relatively heavy head, weaker neck muscles and greater elasticity of vertebral ligaments in this patient population
Due to inheritance elasticity of the pediatric cervical spine which can allow severe spinal cord injury but with the absence of X-ray findings
SCIWORA occurs as a result of hyperextension forces or from a direct frontal impact to the face in most of cases
Causes of SCIWORA
Transverse atlantal ligamentous injury
Fracture through cartilaginous end-plates (Which are not visualized by X-ray), may be among the causes of injury
Unrecognized inter-ligamentous injury
Adult with acute traumatic disc prolapse
Cervical spondylosis:
- C-Spinal injury which is due to hyperextension in the already compromised spine
- Excessive anterior budding of ligamentum flavum into the canal already compromised by posterior vertebral body osteophytes (May cause central cord syndrome)
Diagnosis of SCIWORA
Clinical examination with focus on neurological abnormality should be done
Radiograph is usually performed as diagnosis of exclusion
CT scan will outline the bony pathology
However MRI will outline more anatomical diagnosis and detail injury is investigation of choice
Treatment options
Spine immobilized for at least 12 weeks
Risk activities are avoided for at least 6 months following injury
Devices are removed earlier in stable cases
Post operatively physiotherapy should be done
Reference of above content is taken from mentioned article.
