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SCIWORA is the abbreviation of spinal cord injury without radiographic abnormality 1,2. This may be an indication for MRI when there is persisting, objective myelopathy after a traumatic event with normal plain film and CT findings. It accounts for ~10% of spinal cord injuries.
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Spinal cord injury without radiographic abnormality is more common in the pediatric population. This is due to increased ligamentous laxity and increased head to body ratio in children 4. Children aged less than 8 years are more vulnerable 5.
Electric current injury to the spinal cord, pregnancy complications, congenital spinal malformations, and penetrating trauma to the spinal canal is not included in the criteria 3.
The cervical spinal cord is most commonly involved because of the increased stretchability 4.
History and etymology
Spinal cord injury without radiographic abnormality was first described by two neurosurgeons from the United States of America, Dachling Pang and Jack E. Wilberge Jr, in 1982 5.
- 1. Gelbman AI, Maydew MS. Cervical laminar torus fracture in a child. AJR Am J Roentgenol. 2001;176 (3): 769-70. doi:10.2214/ajr.176.3.1760769 - Pubmed citation
- 2. Kothari P, Freeman B, Grevitt M et-al. Injury to the spinal cord without radiological abnormality (SCIWORA) in adults. J Bone Joint Surg Br. 2000;82 (7): 1034-7. Pubmed citation
- 3. Szwedowski D, Walecki J. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) - Clinical and Radiological Aspects. Pol J Radiol. 2014;79: 461-4. doi:10.12659/PJR.890944 - Free text at pubmed - Pubmed citation
- 4. Atesok, Kivanc, Tanaka, Nobuhiro, O’Brien, Andrew, Robinson, Yohan, Pang, Dachling, Deinlein, Donald, Manoharan, Sakthivel Rajaram, Pittman, Jason, Theiss, Steven. Posttraumatic Spinal Cord Injury without Radiographic Abnormality. (2018) Advances in Orthopedics. doi:https://doi.org/10.1155/2018/7060654
- 5. Pang D, Wilberger JE. Spinal cord injury without radiographic abnormalities in children. (1982) Journal of neurosurgery. 57 (1): 114-29. doi:10.3171/jns.1982.57.1.0114 - Pubmed