Clinical diagnosis and treatment of spinal cord injury without evidence of abnormality in children: a review

Abstract

Spinal cord injury without radiological abnormality (SCIWORA) is a challenging circumstance in all age groups. Symptoms in some children of SCIWORA does not develop at the time of trauma. Different treatment methods (steroid therapy, immobilization, surgery) applied to treat SCIWORA, but with different prognosis. SCIWORA diagnosed when X-rays and computed tomography (CT) normal; however, initial magnetic resonance imaging (MRI) sometimes can be expected. Performing diffusion-weighted imaging (DWI) with early conventional MRI is a gold standard in the diagnosis of SCIWORA. Early MRI and DWI provides a quick diagnosis to facilitate recovery, ensure a superior clinical outcome, and choose a proper treatment method. Although it provides an accurate diagnosis, early immobilization with steroid therapy can present a good prognosis but not in all cases. Durotomy with duraplasty had a good outcome in adult patients, which might be helpful in children. This review explores the current and future methods of diagnosis and treatment of SCIWORA in children.