Real Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) in Pediatrics: A Clinical Case Report and Literature Review

SCIWORA is a condition where someone has signs of spinal cord injury after trauma, but initial X-rays or CT scans don't show any problems like fractures or instability. It's like the spinal cord is injured, but the usual tests don't reveal why. MRI scans can often find the underlying issues, like hidden injuries to ligaments or the spinal cord itself, which were missed by earlier imaging methods. This means the term SCIWORA is now interpreted differently because MRI can detect more subtle problems. There are different types of SCIWORA. 'Real SCIWORA' is diagnosed only when even an MRI doesn't show any damage to the spinal cord, indicating the injury is present despite the lack of visible evidence on imaging.

• 1
  The prognosis of SCIWORA depends on the extent of the spinal cord injury visible on MRI. The absence of visible changes on MRI is associated with a better prognosis.
• 2
  The most common cause of SCIWORA in children is sports-related injuries. It accounted for 41% of injuries, followed by motor vehicle accidents at 26%, falls at 14%, assault at 4%, and being hit with a falling object at 3%.
• 3
  Patients diagnosed with SCIWORA have a wide range of neurological deficits, ranging from mild and transitory symptoms such as paresthesia in the fingers to quadriplegia.