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SCIWORA Syndrome (Spinal Cord Injury without Radiologic Abnormality)

Patrick M. Carey, DO and Jason B. Alisangco, DO, FAAFP Reviewed 06/2019
 


BASICS

Also called spinal cord injury without radiographic evidence of trauma (SCIWORET), spinal cord injury without CT evidence of trauma (SCIWOCTET), or spinal cord injury without neuroimaging abnor...

DIAGNOSIS

HISTORY

  • MVA/MVC

  • Sports-related injury

  • Fall

  • Child abuse

PHYSICAL EXAM

  • Assess for sensorimotor deficit.

  • Abnormal neurologic findings are not accounted for by known/visible injuries.

  • Musculoskeletal ex...

TREATMENT

GENERAL MEASURES

  • Immobilize unconscious patients until plain x-ray and CT radiographs are obtained.

  • Immobilize until able to assess neurologic and pain status.

  • Immobilize patients with transien...

ONGOING CARE

  • SCIWORA can initially present after trauma with no symptoms. Subsequent neurologic deterioration is consistent with the diagnosis.

  • Reassess neurologic function within 24 to 48 hours in pat...

REFERENCES

1
Launay F, Leet AI, Sponseller PD. Pediatric spinal cord injury without radiographic abnormality: a meta-analysis. Clin Orthop Relat Res.  2005;(433):166–170. [View Abstract on OvidMed...

ADDITIONAL READING

  • Piatt JHJr, Campbell JW. Spinal cord injury without radiographic abnormality and the Chiari malformation: controlled observations. Pediatr Neurosurg.  2012;48(6):360–363. [View...

CODES

ICD10

  • S14.109A Unsp injury at unsp level of cervical spinal cord, init

  • S14.2XXA Injury of nerve root of cervical spine, initial encounter

  • S14.102A Unsp injury at C2 level of cervical spinal cord, i...

CLINICAL PEARLS

  • Consider SCIWORA in patients presenting with a history of trauma and neurologic symptoms with negative x-ray and CT findings.

  • The appearance of the spinal cord on MRI helps provide prog...

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