Annals of Rehabilitation Medicine, 2015 · DOI: 10.5535/arm.2015.39.1.146 · Published: March 1, 2015
The case report discusses a rare instance of spinal cord injury without radiologic abnormality (SCIWORA) in an adult patient. Typically, SCIWORA is diagnosed when there's evidence of spinal cord injury but no abnormalities are visible on X-rays or CT scans. However, MRI is more sensitive. In this specific case, the 42-year-old male patient showed tetraplegia (paralysis affecting all four limbs) following a traffic accident. Despite thorough imaging with MRI and CT scans, no lesions or abnormalities were detected in the spinal cord. Adding to the atypical presentation, the patient had normal bladder function, which is unusual for severe spinal cord injuries. However, somatosensory evoked potentials (SEPs) from the lower limbs were absent, confirming a spinal cord injury despite the lack of visible damage on imaging.
This case emphasizes the limitations of relying solely on radiological imaging for diagnosing spinal cord injuries, particularly in cases of SCIWORA.
Somatosensory evoked potential (SEP) testing should be considered as a complementary diagnostic tool in patients presenting with clinical signs of spinal cord injury but without corresponding MRI abnormalities.
Clinicians should be aware of atypical presentations of spinal cord injuries, such as those with normal urodynamic function, to avoid misdiagnosis or delayed treatment.