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SCIWORA in MRI era

Kemal Yucesoy1, K Zafer Yuksel

  • 1Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Clinical Neurology and Neurosurgery
|March 21, 2008
PubMed

Insights

The term Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) is ambiguous since MRI use. Researchers propose renaming it Spinal Cord Injury Without Neuroimaging Abnormality for clarity.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • The term Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) has been used in medical literature.
  • The advent of Magnetic Resonance Imaging (MRI) has complicated the definition and application of SCIWORA.

Purpose of the Study:

  • To analyze the usage and implications of the term SCIWORA in the context of modern neuroimaging.
  • To propose a revised definition for SCIWORA to improve diagnostic clarity.

Main Methods:

  • A literature search was conducted on PubMed using keywords 'SCIWORA and MRI'.
  • 30 relevant English-language articles were reviewed, including meta-analyses, reviews, case series, and case reports.
  • Data on incidence, clinical presentation, radiological findings, and MRI results were evaluated.

Main Results:

  • The incidence of SCIWORA in children varied widely (3.3%–32.0%), influenced by patient age, author specialty, and MRI utilization.
  • The widespread use of MRI has led to an ambiguous interpretation of SCIWORA in published studies.
  • A significant proportion of cases previously labeled SCIWORA may show abnormalities on MRI.

Conclusions:

  • The current definition of SCIWORA is problematic due to the sensitivity of MRI in detecting spinal cord abnormalities.
  • It is recommended to redefine SCIWORA as 'Spinal Cord Injury Without Neuroimaging Abnormality' for cases with completely normal MRI findings.
  • This redefinition aims to reserve the term for injuries with no detectable abnormalities on advanced imaging, enhancing diagnostic precision.

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