Lightning Learning: SCIWORA

““SCIWORA: Spinal Cord Injury Without Radiological Abnormality accounts for 6-19% of spinal cord injuries in children, and 9-14% in adults.””

— advice is based on local guidelines & procedures

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What?

SCIWORA: Spinal Cord Injury Without Radiological Abnormality

Defined as: ‘clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability’ (2)

Neurological symptoms persisting despite normal radiographic images on x-ray or CT of the spine is an indication for an MRI to rule out a cord injury.

Occurs more often in children.

Mainly affects the cervical spine.

Why?

Accounts for 6-19% of spinal cord injuries in children and 9-14% of spinal cord injuries in adults.

When a patient is immobilised following trauma you must ALWAYS examine for neurological deficit BEFORE removing immoblisation even if x-ray or CT is NORMAL to ensure a SCIWORA is not missed.

May present as complete or incomplete spinal cord injury.

Further Reading

1. Radiopaedia: SCIWORA
2. NCBI: Clinical and Radiological Aspects of SCIWORA
3. Ortho Bullets: Incomplete Spinal Cord Injuries