Related Experiment Video
Updated: Oct 2, 2026
A Neonatal Mouse Spinal Cord Compression Injury Model
Published on: March 27, 2016
Spinal Cord Injury without Radiological Abnormality in an 8 Months Old Female Child: A Case Report
Kunal R Bansal1, Ajay S Chandanwale1
1Department of Orthopaedics, B J Govt Medical College, Pune, Maharashtra. India.
Insights
This case report details spinal cord injury without radiological abnormality (SCIWORA) in an 8-month-old infant. Early diagnosis and treatment with corticosteroids and physical therapy are crucial for managing this rare condition.
Area of Science:
- Pediatric neurology
- Traumatology
- Radiology
Background:
- Spinal cord injury without radiological abnormality (SCIWORA) is a rare condition in children, particularly infants.
- While SCIWORA incidence ranges from 8-32%, cases in infants under one year are infrequently documented.
Observation:
- An 8-month-old female presented with complete paralysis of all limbs and absent reflexes following a fall.
- Initial physical examination showed no external spinal abnormalities.
- Cervical spine MRI revealed non-hemorrhagic cord edema at C4 and a suspected anterior longitudinal ligament tear.
Findings:
- The patient was diagnosed with spinal cord injury without radiological abnormality.
- Treatment included immobilization, corticosteroids, and physical therapy.
- The case highlights a rare presentation of SCIWORA in an infant.
Implications:
- This case underscores the importance of considering SCIWORA in infants with neurological deficits, even without radiographic evidence of injury.
- Early intervention with corticosteroids and physical therapy may improve outcomes.
- Advancements in MRI are refining the definition of SCIWORA to include injuries without neuroimaging abnormalities.
Introduction:
Spinal cord injury in children frequently occurs without fracture or dislocation. SCIWORA is a syndrome occurring when the spinal cord sustains neural damage during a traumatic event without positive radiographic findings. The incidence of SCIWORA was found to be 8% to 32% in various studies with very few cases documented in children below the age of 1 year. We report such a case of spinal cord injury without radiological abnormality in an 8 months old female child.
Case Report:
An 8 months old female child was brought to the emergency room after a history of fall from the bed four days back. External spine examination revealed no abnormality. She had no upper or lower limb movements, both active and withdrawal movements with painful tactile stimuli, power was grade 0; are flexic; abdominal cremasteric and anal reflexes were absent, bladder was palpable and urine could be expressed on manual pressure. MRI of cervical spine with screening of whole spine: suggestive of non hemorrhagic cord edema at C4 level, with suspicious tear of anterior longitudinal ligament at that level. The child was immobilized in pediatric cervical collar and treatment was initiated with corticosteroids and the dose adjusted as per age of the patient. A paediatric physiotherapist started with physical therapy after four days of commencement of treatment.
Conclusion:
In present times with wide spread use of MRI, the definition of SCIWORA is slowly turning towards spinal cord injury without neuroimaging abnormality [4]. Traumatic spinal cord infarction is a special type of SCIWORA which presents with normal radiology with delayed neurological deterioration [1]. Corticosteroid usage has been useful in cases of SCIWORA as proved by NASCISII Trial.
Related Concept Videos
01:14Spinal Cord Injury ll: Pathophysiology
01:25Secondary Spinal Cord Injury llI: Pathophysiology