Open Access Journals on Surgery - BJSTR Journal

Abstract

#Spinal cord injury without #radiographic abnormality is a rare and difficult #diagnosis. It is a diagnosis of exclusion, without proven effective treatment, with an evolution often unfavorable. We reviewed the literature to learn more about the diagnostic tools and treatment options available. In this study, we report our experience on 3 cases of Spinal cord injury without radiographic abnormality in children aged 1 to 3 years, in the case of road traffic accidents. Today 2 subjects are paraplegic, 1 tetraplegic, all 3 present urinary disorders. We found no diagnostic tool available and feasible in the acute phase of trauma. MRI can be a good way, but it is often unavailable. Spinal cord injury (SCI) is a rare occurrence in children. The injury level varies according to age, cervical injury is more common in younger children. These injuries are different from adult SCI in light of anatomical and #biomechanical differences between the spinal cord of children and adults: volume and relative weight of the head, ligamentous laxity and immature cervical muscles. This ligamentous laxity explains the #poor radiological semiology found in pediatric SCI. Thus, severe neurological disorders, in the absence of abnormality on standard radiographic imaging, were previously described under the "SCIWORA" syndrome, standing for "Spinal Cord Injury Without Radiographic Abnormality". These traumas in hyperextension, #hyperflexion or axis traction lead to transient displacement of the vertebra that gets back into place without bone lesions, while the spinal cord stretched. we report in this article our experience about 3 cases seen in our department between 2001 and 2014.

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Spinal Cord Injury without Radiographic Abnormality (SCIWORA): About 3 Cases and Review of the Literature by Hayoun T in BJSTR