Sciwora

• Spinal cord injury without  radiographic abnormality
• Defined as objective signs of traumatic myelopathy in children who show no radiographic evidence of skeletal injury or subluxation
• Excludes birth, penetrating & electric shock
• Upper cervical SCIWORA in young kids, Lower SCIWORA is mixed between the child & adolescent age groups
• mechanism may be flexion, extension, distraction & ischemic

Classification

• Early SCIWORA – the acute diagnosis in 50% of cases
• Delayed SCIWORA – delayed onset after a latent period of 1-4 days
• Recurrent SCIWORA – in 15% of cases a second SCIWORA episode occurs at a period of 3days to 10 weeks

Physical Examination

• A complete physical examination is followed by classification of the neurologic injury
• Complete versus partial (central cord, anterior cord, Brown – Sequard )
• Grade as mild if able to walk & severe if ambulation is seriously impaired

Investigation

• investigation includes plain films static, & dynamic
• CT scan if appropriate
• Also an MRI

Treatment

• A steroid protocol should be instituted
• A hard collar or TLSO  is offered
• There is little to offer other than supportive management