A geriatric patient with spinal cord injury without radiographic abnormality: outcomes and causes

Acer, Sevtap; Umay, Ebru; Nazlı, Fatma; Kasman, Ugur Onur; Gündoğdu, İ̇̇brahim; Çakçı, Aytül

doi:10.1038/s41394-018-0050-2

Cited by 2 publications

(1 citation statement)

References 20 publications

(46 reference statements)

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“…The greater elasticity of children's ligaments and joint capsules enables them to withstand considerable stretching without tearing [6]. Further, the high water content of the intervertebral discs enables their longitudinal extension without fracture [7,8]. The vertebral body in children is not fully ossified and is wedge-shaped, resulting in a significantly larger spinal range of motion than that in adults [3,7].…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prognosis of spinal cord injury without radiological abnormality in children in China

Liang

Wang

Hao

et al. 2022

BMC Musculoskelet Disord

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Background Compared to adults, spinal cord injury without radiographic abnormality (SCIWORA) is more common in children due to the congenital spinal soft tissue elasticity and immature vertebral bodies. In this study, we aimed to investigate the risk factors and prognosis associated with SCIWORA in China. Method We retrospectively examined patient records at the First Hospital of Jilin University from January 2007 to December 2020. Patients diagnosed with SCIWORA were included in the study group (n=16). The age, gender, history of trauma, symptoms, injury level of the spinal cord, the American Spinal Injury Association (ASIA) impairment score according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), as well as laboratory and imaging findings were analyzed. Result The study group included 16 patients with SCIWORA with a mean age of 6.69±2.51 y. The ISNCSCI impairment scale was significantly different between the pre-school age patients (≤7 years old) and school age patients (>7 years old) before (P=0.044) and after therapy (P=0.002). Similarly, magnetic resonance imaging demonstrated a significant difference in the spinal injury level between pre-school age and school age patients (P=0.041). Further, the study group was subdivided into three subgroups according to the cause of trauma: Dance, Taekwondo, or Falls. Magnetic resonance imaging revealed significant differences among the three subgroups (P=0.041). Conclusion Compared to school-age patients, pre-school-age patients were more vulnerable to SCIWORA with more severe ISNCSCI scores. Dance and Taekwondo are among the risk factors associated with SCIWORA in Chinese children.

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Section: Introductionmentioning

confidence: 99%

Risk factors and prognosis of spinal cord injury without radiological abnormality in children in China

Liang

Wang

Hao

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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Spinal cord injury without radiologic abnormality: an updated systematic review and investigation of concurrent concussion

Dudney

Sherburn

2023

Bull Natl Res Cent

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Study design Systematic review. Objectives The objectives were to systematically review the literature since the most recent systematic reviews for both adult and pediatric spinal cord injuries without radiologic abnormality (SCIWORA) in order to provide an update on the condition’s epidemiology and characteristics and investigate the relationship between SCIWORA and concurrent concussion. Methods A review was conducted according to the 2020 guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The databases PubMed and OvidSP were searched on February 27, 2022. Inclusion criteria were individuals of any age, diagnosis of SCIWORA with or without abnormalities on MRI, and articles published from 2013 to 2014 (adults only) and 2014–present (all ages). Exclusion criteria were any spinal fracture or dislocation, studies that were narrative reviews, letters, book chapters, or editorials. Risk of bias was assessed using tools from the Clinical Advances Through Research and Information Translation Group at McMaster University and the Joanna Briggs Institute. Collected data were synthesized using Microsoft Excel. Results Since the most recent systematic reviews, a total of 61 studies were identified, resulting in 2788 patients with SCIWORA. 69.55% of patients were pediatric, 30.45% adult. The most prevalent reported mechanism of injury was sports-related (39.56%) followed by fall-related (30.01%) and vehicle-related (27.23%). The vast majority of injuries occurred at the level of the cervical spine (82.59%). Of the 61 included studies, only 5 reported cases of concurrent concussion and/or TBI. Discussion Since the most recent previous systematic reviews, there has been a 64% increase in reported cases of SCIWORA, likely as the result of advances in imaging technology and better awareness of SCIWORA. Still, SCIWORA remains a diagnosis most prevalent in children and young adults, the most common cause being sports-related injury. With the pathogenesis of SCIWORA sharing a predisposition to concussion, the significant lack of reporting of SCIWORA with concurrent concussion suggests that there have been missed diagnoses of either SCIWORA with concurrent concussion or vice versa, leading to longer recovery times, unrecognized and/or untreated underlying pathology, and possibly additional unnecessary morbidity. When the diagnosis of either SCIWORA or concussion is suspected, the other should additionally be considered in order to minimize the possible extended recovery time and related comorbidities. Limitations included the prevalence of lower quality studies such as case reports/series, insufficient reporting of study characteristics, and variability among neurologic impairment scales used and how SCIWORA was defined.

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A geriatric patient with spinal cord injury without radiographic abnormality: outcomes and causes

Abstract: Comorbidities in geriatric SCIWORA have severe effects on both etiology and prognosis. Furthermore, incontinence in SCIWORA is an essential condition that has not been addressed until now and may play a role in prognosis.

Cited by 2 publications

References 20 publications

Risk factors and prognosis of spinal cord injury without radiological abnormality in children in China

Risk factors and prognosis of spinal cord injury without radiological abnormality in children in China

Spinal cord injury without radiologic abnormality: an updated systematic review and investigation of concurrent concussion

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