title: Adult Spinal Cord Injury without Radiographic Abnormalities (SCIWORA): Clinical and Radiological Correlations.
abstract: BACKGROUND
  This study is aimed to determine the clinical and radiological corellations of adult patients with Spinal Cord Injury Without Radiographic Abnormalities (SCIWORA).
  
  
  METHODS
  The study population consisted of all adult patients with suspected cervical spine injury. SCIWORA was defined as the presence of either no injury or a neural injury on Magnetic Resonance Imaging (MRI) in the absence of radiographic or Computed Tomographic (CT) Scan findings suggestive of trauma in patients with neurological deficit. Purely extra neural compressive lesions were excluded from the study.
  
  
  RESULTS
  Twelve of ninety seven (12.4%) patients had a neural injury on MRI with normal radiographs and CT scan. These included cord contusion in five cases, cord edema in five cases and cord hemorrhage in two cases. Ten patients were managed conservatively and two patients with disc prolapse were managed surgically. All patients showed at least one ASIA Impairment Scale (AIS) grade improvement and three patients (25%) recovered completely.
  
  
  CONCLUSIONS
  Parenchymal spinal cord injury is the single most important determinant in the long term outcome of adult SCIWORA patients. Cord hemorrhage has the worst prognosis and cord edema has the best. Longitudinal signal extension and associated extra neural injuries are also associated with poorer outcomes. Cases with purely neural injuries can be managed conservatively, but associated extra neural injuries, especially disc prolapse and ligamentous instability, warrant surgical management.
  
  
  BACKGROUND
  Post Traumatic Myelopathy; Spinal Cord Trauma; Computed tomography; Magnetic resonance imaging; SCIWORA.
authors.affiliation: Postgraduate Department of Orthopedics, Government Medical College, Jammu, India.
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Sharma
authors.forename: Manjeet
authors.initials: M
authors.lastname: Singh
authors.forename: Iftikhar H
authors.initials: IH
authors.lastname: Wani
authors.forename: Sushil
authors.initials: S
authors.lastname: Sharma
authors.forename: Narendra
authors.initials: N
authors.lastname: Sharma
authors.forename: Dara
authors.initials: D
authors.lastname: Singh