Spinal cord injury without radiological abnormality in preschool-aged children: correlation of magnetic resonance imaging findings with neurological outcomes.
OBJECTIVE
Spinal cord injury without radiological abnormality (SCIWORA) was defined in the era when magnetic resonance (MR) images were not popularly used as diagnostic tools. Although it is generally accepted that MR imaging can effectively illustrate the level and severity of spinal cord injury in the acute phase of trauma, only a few reports of MR imaging studies of SCIWORA have been published. The authors retrospectively reviewed nine preschool-aged patients with SCIWORA to study the correlation between MR imaging findings and the outcomes of neurological deficits, with an elimination of the bias for age.


METHODS
Clinical manifestations, radiological images, surgical records, and MR imaging studies were reviewed. The pre- and postoperative neurological statuses of the patients were reappraised using American Spinal Injury Association scores and Nurick grades. Nonparametric tests were used to analyze the correlations among the variables of patient characteristics, MR imaging appearances of the injured spinal cord, and neurological outcome.


CONCLUSIONS
Among the patients with SCIWORA younger than 8 years old, the different patterns of the injured spinal cords could be identified using MR imaging as transection, contusive hemorrhage, traumatic edema, and concussion. The MR imaging patterns of SCIWORA had significant prognostic correlations with the neurological outcomes of these patients; that is, a normal spinal cord appearance was prognostic of a complete recovery of neurological deficits, and intramedullary lesions correlated with permanent deficits with functional disability.
Liao
Cheng-Chih
CC
Department of Neurosurgery, Chang Gung University and Chang Gung Memorial Hospital,d Taoyuan, Taiwan. liao2901@adm.cgmh.org.tw
Lui
Tai-Ngar
TN
Chen
Li-Rong
LR
Chuang
Chi-Cheng
CC
Huang
Yin-Cheng
YC
D000058:Accidental Falls; D000063:Accidents, Traffic; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging