Spinal Cord Injury without Radiological Abnormality in Adults: Clinical and Radiological Discordance

Asan, Ziya

doi:10.1016/j.wneu.2018.03.162

Cited by 17 publications

(15 citation statements)

References 11 publications

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“…The results of MRI in SCIWORA within 3 days were incomplete, and delayed MRI was more significant. 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.…”

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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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: 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 patient subgroup discussed fits in the description of SCIWOCTET. [ 1 2 3 4 5 6 7 ] Considering the aging population, spinal injury in a stenotic cervical spinal has become a more frequent clinical event.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] Several authors subsequently discussed similar clinical entity in adults and labeled it as spinal cord injury without computed tomography evidence of trauma (SCIWOCTET). [ 2 3 4 5 6 7 ] Evidences of spinal degeneration and presence of “stenotic” cervical spinal canal differentiated imaging in adults from that in children. [ 2 3 4 5 6 7 ] There was no evidence of acute disc herniation or focal neural compression that can be attributed to trauma.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 3 4 5 6 7 ] Evidences of spinal degeneration and presence of “stenotic” cervical spinal canal differentiated imaging in adults from that in children. [ 2 3 4 5 6 7 ] There was no evidence of acute disc herniation or focal neural compression that can be attributed to trauma. General observation is that the ultimate clinical outcome of neurological deficits is better in patients having SCIWORA or SCIWOCTET than in those wherein there are evidences of bone or ligamentous disruption that leads to fracture and or dislocation of vertebral segments.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcome following multisegmental cervical spinal fixation in patients who recovered partially following injury

Goel

Lunawat

Shah

et al. 2021

Journal of Craniovertebral Junction and Spine

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Objective: The clinical outcome following multilevel stabilization in patients who suffered cervical spinal injury and developed severe neurological deficits and then gradually partially recovered is evaluated. The basis of the surgical concept was that cervical spinal degeneration is a result of single or multilevel spinal instability and that spinal trauma exaggerates the instability. Materials and Methods: During the period 2015–2020, 14 patients who suffered severe cervical spinal injury and could be included in the classification of spinal cord injury without computed tomography evidence of trauma were surgically treated. There were 11 males and 3 females. The ages ranged from 45 to 67 years, average being 53 years. Cervical canal stenoses related to degenerative spinal changes were observed in all patients. All patients suffered severe neurological deficits and within few days or weeks had shown significant but incomplete neurological recovery. The identification of the levels of unstable spinal segments was done on the basis of radiological and clinical parameters and direct observation of spinal instability in adjoining spinal segments. Transarticular fixation was done by Camille's transarticular fixation technique. Using ASIA score, modified JOA score, and Goel Clinical Grading Scale, the clinical course of the patients was monitored. Results: All patients showed recovery in the neurological status. Recovery started in the immediate postoperative period and the improvement progressed during the period of follow-up. Conclusions: Surgery for spinal stabilization can be indicated even in cases that improve in the neurological function.

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“…Dentro de las patologías detectables solo por RM se encuentran las lesiones extramedulares (hernia de disco, estenosis de canal, lesión de ligamento vertebral común anterior o complejo ligamentario posterior y hematoma intracanal) e intramedulares (edema, contusión y hemorragia) 8,9 . Su relevancia puede ser tan significativa como para determinar el pronóstico del paciente 8,[13][14][15][16][17] .…”

Section: Introductionunclassified

SCIWORA/SCIWORET traumático: experiencia de tres años en un hospital especializado

García-Galicia¹,

Corpus-Mariscal²,

Torreblanca-Reyes³

et al. 2021

RHJM

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Introducción: La SCIWORA (spinal cord injury without radiographic abnormality) es una lesión medular espinal con radiología normal en pacientes con déficit neurológico de origen medular. El acrónimo SCIWORET (spinal cord injury without radiologic evidence of trauma) se emplea en adultos, quienes suelen presentar cambios espondilíticos. Son lesiones devastadoras económica, psicológica y socialmente. Objetivo: Describir la evolución neurológica y calidad de vida de los pacientes con SCIWORA/SCIWORET durante el periodo 2016-2018 en un hospital de 3. er nivel de atención. Material y métodos: Estudio descriptivo, longitudinal, unicéntrico, con seguimiento a pacientes con SCIWO-RA/ SCIWORET, de 5-75 años, durante 2016SCIWORET, de 5-75 años, durante -2018. Se excluyeron pacientes con traumatismo craneoencefálico moderado-grave. Se analizó la evolución neurológica y la calidad de vida mediante las escalas ASIA (American Spinal Injury Association) y EQ-5D (European Quality of Life-5 Dimensions), respectivamente. Se utilizó estadística descriptiva. Resultados: 14 pacientes reclutados, 9 (64%) fueron hombres, edades 7-66 años (media 36.3). La cinemática más frecuente: caída de propia altura (6 pacientes); 9 pacientes calificaron ASIA D, 3 ASIA C y 2 ASIA B. Nueve mejoraron al menos un nivel ASIA a seis meses postrauma. Doce se reintegraron a sus actividades cotidianas y dos presentaron secuelas neurológicas permanentes. Conclusión: La mayoría de los pacientes con SCIWORA/SCIWORET tratados conservadoramente recuperaron al menos un nivel ASIA y registraron buena calidad de vida a seis meses tras la lesión.

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Spinal Cord Injury without Radiological Abnormality in Adults: Clinical and Radiological Discordance

Cited by 17 publications

References 11 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)

Clinical outcome following multisegmental cervical spinal fixation in patients who recovered partially following injury

SCIWORA/SCIWORET traumático: experiencia de tres años en un hospital especializado

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