Spinal cord injury without radiographic abnormality: results of the National Emergency X-Radiography Utilization Study in blunt cervical trauma.
BACKGROUND
The purpose of this study was to better define the incidence and characteristics of patients with spinal cord injury without radiographic abnormality (SCIWORA), using the database of the National Emergency X-Radiography Utilization Study (NEXUS).


METHODS
This was a prospective, observational study of blunt trauma patients in 21 U.S. medical centers undergoing plain cervical radiography. SCIWORA was defined as spinal cord injury demonstrated by magnetic resonance imaging, when a complete, technically adequate plain radiographic series revealed no injury.


RESULTS
Of the 34,069 patients entered, there were 818 (2.4%) with cervical spine injury, including 27 (0.08%) patients with SCIWORA. Over 3,000 children were enrolled, including 30 with cervical spine injury, but none had SCIWORA. The most common magnetic resonance imaging findings among SCIWORA patients were central disc herniation, spinal stenosis, and cord edema or contusion. Central cord syndrome was described in 10 cases.


CONCLUSIONS
In the large NEXUS cohort, SCIWORA was an uncommon disorder, and occurred only in adults.
University of California San Francisco-Fresno, CA 93702, USA. hendey@ucsfresno.edu
Gregory W
GW
Hendey
Allan B
AB
Wolfson
William R
WR
Mower
Jerome R
JR
Hoffman
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D020210:Central Cord Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology; D002574:Cervical Vertebrae; D002648:Child; D016208:Databases, Factual; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy