Document Detail

Absence of MRI soft tissue abnormalities in severe spinal cord injury in children: case-based update.
MedLine Citation:
PMID:  21538127     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Occult spinal cord injury should be suspected based not only on the mechanism of trauma but also on the age of the patient. The pediatric spine has unique biomechanical and anatomical properties that must be considered carefully when evaluating spinal cord trauma. For instance, the hypermobility and elasticity of the spinal column in children often lead to self-reducing injuries that can mask spinal cord injury.
CASE ILLUSTRATION: We present the case of a 22-month-old male patient who was found to have ligamentous injury detected by magnetic resonance imaging (MRI) in the upper cervical spine but missed by MRI in the lower thoracic spine. Furthermore, there was no spinal cord injury in the upper cervical spine, but indeed a serious insult in the thoracic region. Since the advent of MRI, spinal cord injury without radiographic abnormality (SCIWORA) has become increasingly rare but not altogether extinct.
CONCLUSIONS: We present a noteworthy example of the inadequacy of MRI in revealing SCIWORA, a term that is antiquated as we combine the latest imaging techniques with a better understanding of the biomechanics of trauma and spine injury. Based on the literature and our case illustration, we believe that the biomechanics of the pediatric spine must be considered when children who may have sustained a SCIWORA are examined.
Martin M Mortazavi; Nitin R Mariwalla; Eric M Horn; R Shane Tubbs; Nicholas Theodore
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-05-03
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  27     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-15     Completed Date:  2012-03-09     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1369-73     Citation Subset:  IM    
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
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MeSH Terms
Cervical Vertebrae
Magnetic Resonance Imaging
Spinal Cord Injuries / pathology*
Thoracic Vertebrae

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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