Injury to the spinal cord without radiological abnormality (SCIWORA) in adults

Kothari, Pritesh; Freeman, Brian J. C.; Grevitt, Michael; Kerslake, Robert

doi:10.1302/0301-620x.82b7.0821034

Cited by 49 publications

(20 citation statements)

References 16 publications

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“…Patients with soft tissue injuries, such as anterior longitudinal ligament or ligamentum flavum injury, show less ability to improve. The external force reduces the storage capacity of the cervical spinal canal and compresses the spinal cord, which is consistent in the MRI findings of patients after injury [8][9][10][11][12]. MRI was carried out for 2 patients immediately after admission and underwent surgery within 3 days.…”

Section: Discussionsupporting

confidence: 58%

“…Instantaneous external force causes vascular injury of the nutrition spinal cord, bleeding, and edema, which aggravates the vascular injury again, forming a vicious cycle. However, the instability of SCIWORA had not been given enough attention, and cervical dynamic position X-ray should be executed with caution [11]. The diagnosis of SCIWORA in adults depends on plain radiographs and CT. As an important auxiliary means for the diagnosis of such injuries, MRI is becoming more important and is being recommended for routine review of the cervical spine [15].…”

Section: Discussionmentioning

confidence: 99%

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The influence of timing of surgery in the outcome of spinal cord injury without radiographic abnormality (SCIWORA)

Xia

Miao

et al. 2020

J Orthop Surg Res

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Background: Spinal cord injury without radiographic abnormality (SCIWORA) is a rare traumatic myelopathy. Although surgery is one of the most important treatments, the surgery for SCIWORA is controversial, especially the time of surgery is a topic of controversy. Here, we investigate the effects of difference in duration from injury to surgery on the outcome of SCIWORA. Methods: This retrospective study was performed in all patients with spinal cord injury admitted to the Third Affiliated Hospital of Hebei Medical University from January 2013 to April 2017. Fifty-seven patients who met the study requirements were divided into 3 groups according to the duration from injury to surgery. Group A (surgery within 3 days of injury) had 18 patients, group B (surgery within 3-7 days) had 18 patients, and group C (surgery later than 7 days) had 21 patients. All the groups were compared with Mann-Whitney U test; the functional improvement of spinal cord was compared and analyzed using the ASIA sports score and ASIA Impairment Scale (AIS). Results: There was a significant improvement in the long-term AIS (final follow-up) in all the 3 groups compared to before surgery. The final follow-up recovery rate of group C was worse than group A and group B. The curative effect of operation within 7 days was significantly better than the surgery done 7 days later. The recovery rate of group C was worse than group A and B. The ASIA sports score showed that recovery was quicker in the early stage and slow in the later stage. Conclusions: The optimal schedule of surgical treatment was 3-7 days after injury, which can significantly improve the short-term and long-term follow-up effects. Longer the time to surgery from the time of injury, the worse was the prognosis.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

The influence of timing of surgery in the outcome of spinal cord injury without radiographic abnormality (SCIWORA)

Xia

Miao

et al. 2020

J Orthop Surg Res

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“…The comparatively large size of a child’s head, combined with the flexibility of an immature vertebral column renders the paediatric spinal cord particularly vulnerable to these injuries 5. In adults, this is a rare injury, particularly in the intrinsically stable thoracic spine.…”

Section: Discussionmentioning

confidence: 99%

Lower thoracic spinal cord injury without radiographic abnormality in an amateur rugby player

et al. 2012

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“…SCIWORA in adults has been reported in the literature as case reports or series [1, 2]. The treatment regarding this type of injury with either surgery or conservative measures remains controversial [3–6].…”

Section: Introductionmentioning

confidence: 99%

Use of Fidji Cervical Cage in the Treatment of Cervical Spinal Cord Injury without Radiographic Abnormality

Huang

Yan

Wang

2013

BioMed Research International

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Spinal cord injury without radiographic abnormality (SCIWORA) is a rare condition seen in adults. Many interbody fusion cages have been developed for its treatment, but clinical studies of Fidji cervical cage are still scarce. A total number of five patients (four male and one female) were reviewed. The ages of the patients ranged from 40 to 60 years. All the patients underwent neurological and radiological examinations. Neurological and functional outcomes were assessed on the basis of Frankel's grade. Three of the patients were Frankel B, and the rest two were Frankel C. Magnetic resonance imaging was also performed for the evaluation of spinal cord and intervertebral disc injury. Anterior cervical discectomy and Fidji cervical cage fusion were performed for all. The fusion status was evaluated on the basis of X-rays. After surgical intervention, the clinical symptoms improved for all the patients. The disc interspaces in all the patients achieved solid union at final follow-up. Fidji cervical cage is very efficient in achieving cervical fusion in patients with SCIWORA. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory.

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Injury to the spinal cord without radiological abnormality (SCIWORA) in adults

Cited by 49 publications

References 16 publications

The influence of timing of surgery in the outcome of spinal cord injury without radiographic abnormality (SCIWORA)

The influence of timing of surgery in the outcome of spinal cord injury without radiographic abnormality (SCIWORA)

Lower thoracic spinal cord injury without radiographic abnormality in an amateur rugby player

Use of Fidji Cervical Cage in the Treatment of Cervical Spinal Cord Injury without Radiographic Abnormality

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