title: Early magnetic resonance imaging in spinal cord injury without radiological abnormality in adults: a retrospective study.
abstract: BACKGROUND
  The purpose of this study was to describe the clinical and imaging characteristics of patients experiencing blunt spinal trauma without radiological abnormalities but transient or persistent neurological deficits.
  
  
  METHODS
  This retrospective study analyzed plain radiographs, computed tomographic scans, and magnetic resonance images of patients with spinal cord injury without radiological abnormality (SCIWORA) who were admitted to a Level I trauma center. Neurologic status, Frankel grade, and short-term patient outcome were assessed.
  
  
  RESULTS
  Of 1,604 patients experiencing blunt spinal trauma, 21 (12 men and 9 women) with a mean age of 35.5 years (range, 16.2-70.9 years) presented with a clinicoradiographic mismatch. Magnetic resonance imaging (MRI) was available in 15 patients. In seven patients (46.6%), MRI revealed either neural (n = 2, 13.3%) or extraneural (n = 5, 33.3%) spinal abnormalities. Importantly, in eight patients (53.3%), no spinal abnormalities were visible on MRI. Furthermore, subgroup analysis revealed no prognostic value regarding the presence or absence of detectable spinal injuries.
  
  
  CONCLUSIONS
  Spinal abnormalities were not detected on MRI in a substantial proportion of patients presenting with SCIWORA. The prognostic value of MRI findings in SCIWORA needs to be validated by future studies.
  
  
  METHODS
  Epidemiological study, level V.
authors: Department of Trauma, University Hospital Giessen and Marburg, Marburg, Germany.
authors: Christoph Kolja
authors: CK
authors: Boese
authors: Michael
authors: M
authors: Nerlich
authors: Silvan Maximilian
authors: SM
authors: Klein
authors: André
authors: A
authors: Wirries
authors: Steffen
authors: S
authors: Ruchholtz
authors: Philipp
authors: P
authors: Lechler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*; D055815:Young Adult