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  • Writer's pictureDr Josh Bonine DC

Spinal Cord Injury Without Radiographic Abnormalities

Spinal Cord Injury Without Radiographic Abnormalities



When assessing the traumatically injured, correlation of findings is paramount. Do the physical, neurological and orthopedic examinations correlate with the radiographic and advanced imaging results? Kasimatis et al. (2008) published a paper on SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) in which they state “SCIWORA is thought to represent mostly a pediatric entity and its incidence in adults is rather underreported” (p. 86). “Differences in radiological and clinical examination findings in patients with spinal cord injury can occur and pose challenges to their management” (p.86). These injuries are also influenced by degenerative changes in the adult spine, such as bone spurs, narrowed spinal canal and degenerative disc disease, where the cord can be stretched over these structures with hyperextension injuries. Cord Concussion Syndrome can also occur, which can result in negative MRI findings at which time. Finally, it was stated “MR imaging has substantially aided in our understanding of the pathomorphology of SCIWORA, revealing the following distinct abnormality: pressure exerted by the intervertebral disc and/or the ligamentum flavum, and epidural hematoma.” (Kasimatis et al., 2008, p. 91). Proper diagnosis of spinal cord trauma can be difficult and correlation of all clinical and imaging findings will allow trauma patients to receive proper specialist referral and appropriate medical interventions.




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Reference:


Kasimatis, G. B., Panagiotopoulos, E., Megas, P., Matzaroglou, C., Gliatis, J., Tyllianakis, M., & Lambiris, E. (2008). The adult spinal cord injury without radiographic abnormalities syndrome: Magnetic resonance imaging and clinical findings in adults with spinal cord injuries having normal radiographs and computed tomography studies. The Journal of Trauma Injury, Infection, and Critical Care, 65(1), 86-93.


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