Spinal cord injury without radiologic abnormality in children imaged with magnetic resonance imaging

Prashant Mahajan, David M. Jaffe, Cody S. Olsen, Jeffrey R. Leonard, Lise E. Nigrovic, Alexander J. Rogers, Nathan Kuppermann, Julie C. Leonard

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

BACKGROUND: This study aimed to compare children diagnosed with cervical spinal cord injury without radiographic abnormality (SCIWORA) relative to whether there is evidence of cervical spinal cord abnormalities on magnetic resonance imaging (MRI). METHODS: We conducted a planned subanalysis of a cohort of children younger than 16 years with blunt cervical spine injury presenting to Pediatric Emergency Care Applied Research Network centers from January 2000 to December 2004 who underwent cervical MRI and did not have bony or ligamentous injury identified on neuroimaging. We defined SCIWORA with normal MRI finding as children with clinical evidence of cervical cord injury and a normal MRI finding and compared them with children with SCIWORA who had cervical cord signal changes on MRI (abnormal MRI finding). RESULTS: Of the children diagnosed with cervical spine injury, 55% (297 of 540) were imaged with MRI; 69 had no bony or ligamentous injuries and were diagnosed with SCIWORA by clinical evaluation; 54 (78%) had normal MRI finding, and 15 (22%) had cervical cord signal changes on MRI (abnormal MRI finding). Children with abnormal MRI findings were more likely to receive operative stabilization (0% normal MRI finding vs. 20% abnormal MRI finding) and have persistent neurologic deficits at initial hospital discharge (6% normal MRI finding vs. 67% abnormal MRI finding). CONCLUSION: Children diagnosed with SCIWORA but with normal MRI finding in our cohort presented differently and had substantially more favorable clinical outcomes than those with cervical cord abnormalities on MRI.

Original languageEnglish (US)
Pages (from-to)843-847
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume75
Issue number5
DOIs
StatePublished - Nov 2013

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Spinal Cord Injuries
Magnetic Resonance Imaging
Wounds and Injuries
Spine
Emergency Medical Services
Neurologic Manifestations
Neuroimaging
Cervical Cord

Keywords

  • Emergency medicine
  • MRI
  • Pediatric
  • Radiology
  • Spinal cord

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Mahajan, P., Jaffe, D. M., Olsen, C. S., Leonard, J. R., Nigrovic, L. E., Rogers, A. J., ... Leonard, J. C. (2013). Spinal cord injury without radiologic abnormality in children imaged with magnetic resonance imaging. Journal of Trauma and Acute Care Surgery, 75(5), 843-847. https://doi.org/10.1097/TA.0b013e3182a74abd

Spinal cord injury without radiologic abnormality in children imaged with magnetic resonance imaging. / Mahajan, Prashant; Jaffe, David M.; Olsen, Cody S.; Leonard, Jeffrey R.; Nigrovic, Lise E.; Rogers, Alexander J.; Kuppermann, Nathan; Leonard, Julie C.

In: Journal of Trauma and Acute Care Surgery, Vol. 75, No. 5, 11.2013, p. 843-847.

Research output: Contribution to journalArticle

Mahajan, Prashant ; Jaffe, David M. ; Olsen, Cody S. ; Leonard, Jeffrey R. ; Nigrovic, Lise E. ; Rogers, Alexander J. ; Kuppermann, Nathan ; Leonard, Julie C. / Spinal cord injury without radiologic abnormality in children imaged with magnetic resonance imaging. In: Journal of Trauma and Acute Care Surgery. 2013 ; Vol. 75, No. 5. pp. 843-847.
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