OrthoNet

Spine - SCIWORA

Spinal Cord Injury Without Radiographic Abnormality

- usually less than 8 years old; most with severe spinal cord involvement are less than 4
- related to hypermobility of c-spine
- the injuries may not be mechanically unstable

Need x-rays, CT, MRI - look at the cord

It is possible that none of the investigations will show an osseous or even a ligamentous injury

- key to treatment is to provide protection against further spinal cord damage.

- rarely need surgery (only if you see a lesion that needs fixing!)

- usually, there is no radiographic or MRI signs of instability and the child is treated with some form of orthosis

- watch for late spinal paralytic deformity in a kid with quadriplegia. In children who are paralyzed prior to the teenage growth spurt - all develop spinal deformity - 80% of which will be progressive, 61% of which will need spinal fusion.