SCIWORA in MRI era

Yücesoy, Kemal; Yüksel, Kasım Zafer

doi:10.1016/j.clineuro.2008.02.004

Cited by 86 publications

(60 citation statements)

References 31 publications

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“…Under these conditions, conventional MRI images could not differentiate secondary lesions from primary ones. In Yucesoy's opinion [24], the real SCIWORAs should be termed as ''spinal cord injury without neuroimaging abnormality''. Those cases with negative MRI results should be evaluated carefully.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Guo

Liu

et al. 2011

Eur Spine J

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Introduction The epidemiology of spinal cord injury without radiographic abnormality (SCIWORA) is less frequently reported in adults as compared with children. ResultsIn total, 203 patients were enrolled. The average age among the adult groups was 55.9 years (men 55.8 years, women 53.6 years). SCIWORA occurred more commonly in adults in the 46-60 age group, and falls were the leading cause of injury (52.2%), followed by vehicular injury (28.6%). The most predominantly affected level was C4/5 (48.7%), followed by C5/6 (30.5%) and C3/4 (12.8%), respectively. The occurrence of central cord syndrome (50.2%) with posterior longitudinal ligament tear (43.8%) was relatively higher than other injury patterns. Conclusion It is clear that adult cervical SCIWORA is different from that in the pediatric group. Our study highlights the epidemiological properties of adult SCIW-ORA in Tianjin, China. Differing from other reports, particularly epidemiology study, we represent the first report regarding adult SCIWORA from China. As the geriatric population increases, it is very important to set up an individualized evaluation system based on a nationally scaled epidemiological database. The results from our study will be useful in assisting in the creation of such a database.

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Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Guo

Liu

et al. 2011

Eur Spine J

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“…1 The development of MRI has increased the diagnostic accuracy of neuroimaging by visualising the soft tissue injuries and also pathologies causing the spinal cord compression, which has lead to a controversy in the definition of SCIWORA. 9,10 The term of spinal cord injury without radiographic evidence of trauma (SCIWORET), which occurs in combination with cervical spondylosis, spinal stenosis, disc herniation and so on, and real SCIWORA, which excludes all neuroimaging abnormalities, have also been established. 3,9 As there is no common consensus for a new terminology, we still use the term SCIWORA in description of the syndrome of spinal cord injury without fracture or dislocation in plain radiographs, although patients presented spinal stenosis, disc herniations and so on, in MRI scans.…”

Section: Resultsmentioning

confidence: 99%

“…9,10 The term of spinal cord injury without radiographic evidence of trauma (SCIWORET), which occurs in combination with cervical spondylosis, spinal stenosis, disc herniation and so on, and real SCIWORA, which excludes all neuroimaging abnormalities, have also been established. 3,9 As there is no common consensus for a new terminology, we still use the term SCIWORA in description of the syndrome of spinal cord injury without fracture or dislocation in plain radiographs, although patients presented spinal stenosis, disc herniations and so on, in MRI scans. The severity of neurological injuries caused by SCIWORA varies from complete cord transsection with permanent tetra-or paraplegia to mild transient neurological deficit.…”

Section: Resultsmentioning

confidence: 99%

“…[2][3][4][5][6][7][8] The development of magnetic resonance imaging (MRI) has increased the diagnostic accuracy in the assessment of spinal cord injuries, but it has also lead to a controversy regarding the definition of SCIWORA by visualisation of soft tissue injuries. 9,10 Moreover, using MRI scan, adult patients with SCIWORA have been found to present disc herniations, ossification of the posterior longitudinal ligament, spinal canal stenosis and cervical spondylosis as predisposing factors for spinal cord injury. [2][3][4][5][6][7][8] The outcome of patients with SCIWORA has considerable variation according to the severity of the injury.…”

Section: Introductionmentioning

confidence: 99%

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Neurological outcome, working capacity and prognostic factors of patients with SCIWORA

et al. 2011

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Study design: Retrospective case review. Objectives: In the present study, the neurological outcome, retirement and prognostic factors of patients with spinal cord injury without radiographic abnormality (SCIWORA) were evaluated. Setting: Swiss national work accident insurance database. Methods: The medical histories of 32 patients who were insured by the Swiss Accident Insurance Fund (SUVA) and had SCIWORA between 1995 and 2004 were evaluated thoroughly. Moreover, all available magnetic resonance imaging (MRI) scans were evaluated. Results: At the last follow-up, none of the patients had complete spinal cord injury, only 4 patients had severe deficits and 12 patients had normal motor and sensory function in the neurological examination. However, only 7 out of 32 patients had returned to full-time work and 10 out of 32 patients were fully retired. Both the presence of spinal cord change (r¼0.51) and higher maximum spinal cord compression (r¼0.57) in MRI scan correlated with the likelihood for retirement; older age (r¼0.38) and physical load of work (r¼0.4) correlated with retirement to a lesser extent. Conclusion: Although the neurological outcome of SCIWORA is mostly good, the retirement rate is high. Presence of spinal cord change and severity of cord compression are the best predictors for the degree of retirement.

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“…There has been much debate about the relevance of the term SCIWORA in an age where MRI is readily available and often performed as initial investigation in patients with spinal injuries. Several alternatives have been suggested, such as SCIWORET (SCI without radiographic evidence of trauma), SCIWOCTET (SCI without CT-evidence of trauma) 12 or SCIWONA (SCI without neuroimaging abnormality), 13 which may be a more accurate and relevant description of this particular injury.…”

Section: Mri Findingsmentioning

confidence: 99%

Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

et al. 2017

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Purpose of study: Prolonged bracing following injury in patients with Spinal Cord Injury without Radiographic Abnormality (SCIWORA) remains controversial. Some authors claim that there is occult instability and a risk of recurrent injury whereas others propose that the spinal column will deform elastically, but will return to its baseline stability by elastic recoil. We aim to assess the presence of ligamentous injury on MRI and the incidence of recurrent instability following SCIWORA in order to determine the need for prolonged bracing.Methods: A retrospective chart review was performed for a series of 12 patients with documented SCIWORA that presented to Red Cross Children's Hospital over the past 8 years. Details regarding mode of injury, age at presentation, neurological deficit at presentation, MRI findings and long-term prognosis were documented.Results: There were nine males and three females. The median age was 4.35 years. All patients were victims of high energy motor vehicle accidents. In two patients there was disruption of the ligamentum flavum at the level of the injury. There were no episodes of recurrent instability or neurological compromise in those patients that had recovered. None of our patients had rigid bracing following the diagnosis of SCIWORA. Conclusion:Infrequently observed disruption of isolated stabilising structures in SCIWORA did not lead to early or delayed instability in our patients. We did not find evidence to support the practice of prolonged rigid bracing to prevent recurrence following SCIWORA. Level of evidence: Prognostic case study, level IVKey words: SCIWORA, paediatric spinal cord injury, MRI findings in SCIWORA, bracing in SCIWORA, paediatric trauma http://dx

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SCIWORA in MRI era

Cited by 86 publications

References 31 publications

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Neurological outcome, working capacity and prognostic factors of patients with SCIWORA

Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

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