Occult spinal cord injury in traumatized children

The existence of spinal cord injury without radiological abnormality (SCIWORA) has been recognized for some years. Two cases of SCIWORA in children are presented which highlight the possibility of severe spinal cord injury without any physical or radiological signs. The injury may occur at any level. It is recommended that normal procedures used for spinal immobilization in adults are inappropriate in the case of children and all unconscious children should be treated with full spinal immobilization until clinical assessment of neurological function is possible.