Thoracic Spinal Cord Injury Without Radiographic Abnormality in a Skeletally Mature Patient

Abstract

A rare case of thoracic spinal cord injury without radiographic abnormality manifested as a result of traction injury to the sciatic nerves caused by bilateral violent lower limb injuries in a skeletally mature patient is presented. To the best of the authors' knowledge, such a case has not been reported previously.

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

“…Thin section and high magnetic field MRI examinations can reveal lesions that cannot be monitored with routine MRI scans [13]. Samsani et al [14] believed that after spinal injury, paravertebral venous plexus was abnormal, veins were tortuous and irritated, and paravertebral venous backflow was stagnant, which explained that the SCI segment was higher than the compression segment shown in MRI. The hemodynamics of SCI suggested that compressions could cause spinal cord vascular obstruction and thus alter the hemodynamics of the spinal cord.…”

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

“…Previous cases of thoracic SCIWORA in adult patients have been reported at T4 and above 3 4. One case report describes SCIWORA at T10 in a severely poly-traumatised patient but following significant high energy lower limb injuries 2. The authors proposed that sudden bilateral traction on the sciatic nerves accounted for the observed cord injury in this particular case.…”

“…Spinal cord injury without radiographic abnormality (previously known as SCIWORA) is exceedingly rare in skeletally mature individuals, with very few previous case-reports,2–4 most of which occurred in the context of high energy polytrauma. To our knowledge, this is the first reported case occurring in the lower thoracic spine as an isolated injury following a low-energy mechanism.…”

Thoracic spinal cord injury without major bone injury associated with ossification of the ligamentum flavum

“…Samsani et al reported a case of thoracic spinal cord injury without radiographic abnormality in a skeletally mature patient, and associated spinal ligamentous injuries were excluded by MRI [6]. CT is recommended because it demonstrates thoracic OLF distribution patterns.…”