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Jian Ren, Gao Zeng, Yong-Jie Ma, Nan Chen, Zan Chen, Feng Ling, Hong-Qi Zhang
PURPOSE: The purpose of the study was to describe a unique type of low-energy traumatic pediatric thoracic spinal cord injury without radiographic abnormality (SCIWORA) after a back bend during dance practice and analyze the trauma mechanisms and treatment protocols. METHODS: This was a retrospective case series from September 2007 to August 2016. The study was conducted at a tertiary medical center in Beijing, China (Xuanwu Hospital, China International Neuroscience Institute [China-INI], Capital Medical University)...
April 4, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
Casey J Madura, James M Johnston
Appropriate management of subaxial spine injury in children requires an appreciation for the differences in anatomy, biomechanics, injury patterns, and treatment options compared with adult patients. Increased flexibility, weak neck muscles, and cranial disproportion predispose younger children to upper cervical injuries and spinal cord injury without radiographic abnormality. A majority of subaxial cervical spine injuries can be treated nonoperatively. Surgical instrumentation options for children have significantly increased in recent years...
January 2017: Neurosurgery Clinics of North America
Lynn Babcock, Cody S Olsen, David M Jaffe, Julie C Leonard
OBJECTIVE: The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities. METHODS: This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury from sports or recreational activities (n = 179)...
September 30, 2016: Pediatric Emergency Care
J J Wyndaele
No abstract text is available yet for this article.
October 2016: Spinal Cord
Kunal R Bansal, Ajay S Chandanwale
INTRODUCTION: Spinal cord injury in children frequently occurs without fracture or dislocation. SCIWORA is a syndrome occurring when the spinal cord sustains neural damage during a traumatic event without positive radiographic findings. The incidence of SCIWORA was found to be 8% to 32% in various studies with very few cases documented in children below the age of 1 year. We report such a case of spinal cord injury without radiological abnormality in an 8 months old female child. CASE REPORT: An 8 months old female child was brought to the emergency room after a history of fall from the bed four days back...
January 2016: Journal of Orthopaedic Case Reports
Christopher Kim, Michael Vassilyadi, Jason K Forbes, Nicholas W P Moroz, Alexandra Camacho, Paul J Moroz
BACKGROUND: With a reported incidence of up to 10% compared to all spinal trauma, spinal injuries in children are less common than in adults. Children can have spine fractures with or without myelopathy, or spinal cord injuries without radiological abnormalities (SCIWORA). METHODS: We retrospectively reviewed the cases of children with spinal injuries treated at a level 1 pediatric trauma centre between 1990 and 2013. RESULTS: A total of 275 children were treated during the study period...
June 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Jeffrey Knox
PURPOSE: To characterize the epidemiology and costs associated with spinal cord injury without radiographic abnormality (SCIWORA) based on patient age. METHODS: An analysis of data complied for 2012 in the Healthcare Utilization Project KID database (HCUP-KID), which represents a nationwide database of pediatric admissions, was performed. An initial search identified all children diagnosed with SCIWORA based on International Classification of Diseases, 9th edition (ICD-9) codes...
June 2016: Journal of Children's Orthopaedics
Manuel Ribeiro da Silva, Daniela Linhares, Pedro Cacho Rodrigues, Eurico Lisboa Monteiro, Manuel Santos Carvalho, Pedro Negrão, Rui Peixoto Pinto, Nuno Neves
PURPOSE: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. METHODS: Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. RESULTS: Seventy-five cases of C-spine injuries (nine SCIWORA) were identified...
June 2016: International Orthopaedics
Pietro Fiaschi, Mariasavina Severino, Giuseppe Marcello Ravegnani, Gianluca Piatelli, Alessandro Consales, Andrea Accogli, Valeria Capra, Armando Cama, Marco Pavanello
BACKGROUND: Spontaneous or idiopathic intramedullary bleeding is a very rare event in pediatric patients. This diagnosis requires an extended clinical, laboratory, and radiologic work-up to rule out all potential causes of hematomyelia. However, children may present with hematomyelia or spinal cord injury without radiographic abnormality even after a minor trauma. CASE DESCRIPTION: A 15-month-old girl presented with a 24-hour history of progressive neurologic deficits...
June 2016: World Neurosurgery
Jun Ouchida, Yasutsugu Yukawa, Keigo Ito, Yoshito Katayama, Tomohiro Matsumoto, Masaaki Machino, Taro Inoue, Keisuke Tomita, Fumihiko Kato
STUDY DESIGN: A prospective imaging study to develop diagnostic criteria. OBJECTIVE: The aim of this study was to investigate image findings on delayed magnetic resonance imaging (MRI) after the acute phase of spinal cord injury without radiographic abnormality (SCIWORA) and their relationship with symptom severity. SUMMARY OF BACKGROUND DATA: MRI is used to diagnose acute neurological injury, with increased signal intensity (ISI) and prevertebral hyperintensity (PVH) often seen in patients with SCIWORA; however, changes after the acute phase are unclear...
August 15, 2016: Spine
C K Boese, D Müller, R Bröer, P Eysel, B Krischek, H C Lehmann, P Lechler
OBJECTIVES: The present study aimed to analyse the clinical and neuroimaging features of a consecutive series of adult patients with spinal cord injury without radiographic abnormality (SCIWORA) receiving early magnetic resonance imaging (MRI), and to apply the recently proposed MRI classification system. METHODS: Grade of neurologic impairment at admission and discharge was reported according to the American Spinal Injury Association Impairment Scale (AIS). A detailed analysis and categorisation of the extra- and intramedullary MRI findings was performed, and the relationship between imaging type and neurological outcome was described...
October 2016: Spinal Cord
John I Shin, Nathan J Lee, Samuel K Cho
STUDY DESIGN: A retrospective administrative database analysis. OBJECTIVE: The aim of this study was to investigate the incidence and characteristics of pediatric cervical spine injury (PCSI) utilizing the Kids' Inpatient Database (KID). SUMMARY OF BACKGROUND DATA: PCSI is debilitating, but comprehensive analyses have been difficult due to its rarity. There have been a few database studies on PCSI; however, the studies employed databases that suffer from selection bias...
February 2016: Spine
Ji-dong Zhang, Qun Xia
OBJECTIVE: To determine the features of discs in spinal cord injury without radiographic abnormality (SCIWORA) by intraoperative disc contrast injection (IODCI) and to subsequently treat the responsible discs operatively. METHODS: From January 2007 to December 2011, 16 adult cases of cervical SCIWORA were enrolled in this study. The average preoperative Japanese Orthopaedic Association (JOA) score was 9.1 ± 1.8. Although preoperative imaging showed no obvious fracture or dislocation, spinal cord compression was evident in all cases...
August 2015: Orthopaedic Surgery
T Carroll, C D Smith, X Liu, B Bonaventura, N Mann, J Liu, N A Ebraheim
STUDY DESIGN: Systematic review. OBJECTIVES: The objective of this study is to systematically review the literature for pediatric cases of spinal cord injuries without radiologic abnormality (SCIWORA) to investigate any possible relationship between initial neurologic impairment and eventual neurologic status. SETTING: A university department of orthopedics. METHODS: Following the preferred reporting items for systemic reviews and meta-analysis (PRISMA) guidelines for systematic review, the databases of PubMed and OvidSP were electronically searched for articles that use individuals under 18 years old, have trauma resulting in spinal cord injury and have no fractures or dislocations on radiographs...
December 2015: Spinal Cord
Yi Wang, Yuan Xue, Yaqi Zong, Huairong Ding, Zhiyang Li, Dong He, Yanming Tang, Ying Zhao, Pei Wang
In general, spinal cord injury without radiological abnormality (SCIWORA) with spondylosis is considered to be a central cord injury. This article describes the clinical features and surgical outcomes of atypical central cord injury in patients with spondylotic SCIWORA (ACCISS). Fifty-two patients were enrolled in the study from January 2006 to December 2011. Diagnoses were made from imaging (computed tomography, magnetic resonance imaging) and clinical findings. The neurologic status of patients was assessed using the American Spinal Injury Association (ASIA) score and Japanese Orthopaedic Association (JOA) score...
June 2015: Orthopedics
Christoph Kolja Boese, Johannes Oppermann, Jan Siewe, Peer Eysel, Max Joseph Scheyerer, Philipp Lechler
BACKGROUND: Spinal cord injury in children is associated with severe morbidity and immense socioeconomic burden. In spinal cord injury without radiologic abnormalities (SCIWORA), magnetic resonance imaging (MRI) can detect intramedullary or extramedullary pathologies or show absence of neuroimaging abnormalities. However, the prognostic and therapeutic consequences of specific MRI patterns are unclear. A comprehensive systematic literature search was performed to examine patient characteristics and imaging patterns of pediatric SCIWORA and to evaluate the prognostic value of a MRI-based classification system...
April 2015: Journal of Trauma and Acute Care Surgery
Q Liu, Q Liu, J Zhao, H Yu, X Ma, L Wang
STUDY DESIGN: Adult spinal cord injury without radiologic abnormalities (SCIWORA) is evidenced to be underreported. Some abnormalities that were not present on computed tomography (CT) were identified on magnetic resonance imaging (MRI), but the diagnostic reliability of early MRI remains considerable disagreement. OBJECTIVE: The present study was retrospectively designed to assess a potential correlation between clinical and imaging findings in adults experiencing SCIWORA...
October 2015: Spinal Cord
Ji Woong Park, Yang Gyun Lee, Yoon-Hee Choi, Joon Won Seo, Seok Min Lee, Jin Il Kim, Yong Jae Ko
Although spinal cord injury without radiographic abnormality (SCIWORA) literally refers to the specific type of spinal cord injury, however, some extents of spinal cord injuries can be detected by magnetic resonance imaging (MRI) in most of cases. We introduce an atypical case of spinal cord injury without radiologic abnormality. A 42-year-old male tetraplegic patient underwent MRI and computed tomography, and no specific lesions were found in any segments of the spinal cord. Moreover, the tetraplegic patient showed normal urodynamic function despite severe paralysis and absent somatosensory evoked potentials from the lower limbs...
February 2015: Annals of Rehabilitation Medicine
Kavin Khatri, Kamran Farooque, Ankit Gupta, Vijay Sharma
INTRODUCTION: Spinal cord injury without radiological abnormality (SCIWORA) is a rare entity and usually involves the cervical spine. Thoracic spine involvement is very rare due to the stability provided by the rib cage. The mechanisms of injury and pathophysiology are still debatable. CASE PRESENTATION: We present a case of an adult male who had road traffic accident and presented with paraplegia. The initial radiological investigations carried out in the emergency department were reported to be normal, however, subsequent magnetic resonance imaging revealed spinal cord contusion without vertebral column disruption...
September 2014: Archives of Trauma Research
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