Spinal cord injury without radiographic abnormality (SCIWORA) in children: A Kolkata experience

Spinal cord injury without radiographic abnormality can result in severe neurological deficit. Early recognition of this syndrome is important so that treatment can be instituted. This study was carried out to analyze the incidence, clinical features, diagnosis including MRI features, and therapeutic approaches. Out of sixty five cases of spinal injury below 12 years of age admitted in the emergency Neurosurgery ward of IPGMER, Kolkata between August 2006 and December 2008, nine patients diagnosed as SCIWORA were included in this study. The patients were assessed for mechanism of injury, radiographic assessment by X ray of spine in all patients and CT Scan in some patients. All patients underwent MRI. Clinical assessment of patients was done using ASIA impairment scale at the time of admission, discharge and on follow-up at 3 months and 6 months interval. Majority of patients were below 8 years of age (66.67%). Fall was the commonest mode of injury and cervical spine was the commonest site of injury. Majority of patients had an abnormality on MRI. SCIWORA is relatively common in pediatric patients with spinal injury and early treatment is associated with good outcome. MRI is helpful in predicting the outcome.