SCIWORA


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SCIWORA

Spinal cord injury without radiologic abnormality Neurosurgery Serious spinal cord damage and disruption of tracts without a Fx, an event that is most common in children Mechanisms Flexion, hyperextension, longitudinal distraction and ischemia causing complete severe partial cord lesions Management Regional stabilization, exploration
References in periodicals archive ?
The most common causes of injury in patients with SCIWORA are sports injuries, motor vehicle collisions, falls, and abuse [2, 10, 13].
In a study of nationwide pediatric admissions, Knox [13] reported that 87% of patients with SCIWORA had associated injuries, and head trauma was the most common injury (between 28 to 64%), followed by orthopaedic injuries (10%), facial injuries (9%), thoracic injuries (9%), and gastrointestinal injuries (4%).
Published reports indicate that patients with SCIWORA may present with a wide range of neurological findings, including para/hemiparesis/plegia, paresthesia, changes in tendon reflexes, loss of bladder and bowel function, signs of anterior/central/posterior cord or Brown-Sequard syndrome in addition to local pain, sensitivity, abrasions, and bruising around the vertebral column [2, 11, 12, 17, 23].
The incidence of SCIWORA in adults is as low as 0.08%-15% except for the elderly population (>60 years) where the incidence is comparatively higher due to degenerative pathologies.2 The rarity of adult SCIWORA poses a diagnostic challenge for clinicians and relies immensely on clinical skills to identify intra neural injury despite normal X-ray films and CT scans in the presence of progressive neurological deficits.
On the basis of clinical presentation and MRI, patient was diagnosed as a case of SCIWORA. He was initially managed conservatively with complete bed rest and rigid neck immobilization.
Based on it, a clinical diagnosis of SCIWORA was made.
In view of history of significant trauma, paraplegia, normal X-Rays, CT and MRI, a diagnosis of SCIWORA was made.
Most cases of SCIWORA occur in cervical spine on account of its hypermobility and vulnerability to traumatic injury3.
Acute management in children with SCIWORA con- sists of maintenance of spinal immobilization, emergent support of airway, breathing and circulation while treating other life-threatening injuries and emergent consultation with a neurosurgeon with pediatric expertise5.
Radyografik Bozukluk Gostermeyen MSY (SCIWORA: Spinal Cord Injury Without Radiologic Abnormalities)
SCIWORA, travma sonrasi objektif miyelopati bulgulari olmasina ragmen omurganin direk radyografilerinde, tomografilerinde ve miyelografilerinde kirik veya dislokasyon bulgusunun olmamasi seklinde tanimlanan, manyetik rezonans goruntuleme (MRG) oncesi bir terimdir (25-27).
SCIWORA'larda en sik lezyon servikotorasik bileskededir ve servikal lezyonlarin prognozu daha kotudur.