title: Pediatric spinal cord injury without radiographic abnormality in the era of advanced imaging.
abstract: OBJECTIVE
  The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes.
  
  
  RESULTS
  Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings. Through case studies and national database analyses, researchers have further defined the epidemiology and outcomes of SCIWORA.
  
  
  CONCLUSIONS
  Although SCIWORA occurs infrequently, thus making robust research a challenge, maintaining a high suspicion in the appropriate clinical setting ought to prompt acquisition of advanced imaging. For patients with persisting neurologic symptoms after trauma, despite negative plain films and cervical spine computed tomography, MRI can be helpful diagnostically as well as prognostically. Once SCIWORA is diagnosed, patients are treated nonoperatively with hard collar immobilization and physical therapy.
authors.affiliation: aDivision of Emergency Medicine bDepartment of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Caitlin A
authors.initials: CA
authors.lastname: Farrell
authors.forename: Megan
authors.initials: M
authors.lastname: Hannon
authors.forename: Lois K
authors.initials: LK
authors.lastname: Lee
mesh_terms: D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D010372:Pediatrics; D011379:Prognosis; D011859:Radiography; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy