What is Emergency Medicine - What is SCIWORA?
Spinal Cord Injury Without Radiographic Abnormality is referred to as SCIWORA. Before thin-slice CT and MRI were widely available, the term "SCIWORA" was applied to children who had substantial spinal cord injuries but normal x-rays or CT scans (most commonly cervical). We now know that these injuries may be seen on an MRI and are more common in adults than in children. Children and adults who exhibit neurologic symptoms (radicular or myelopathic) but who have normal x-ray or CT scan results should have further MRI testing in the emergency department. Patients who experience short-lived, temporary symptoms of the spinal cord should also get an MRI because these symptoms could indicate spinal cord stretching, which could indicate delayed cord edema and recurring spinal cord disease. Patients who have persistent spinal pain or discomfort but no neurologic symptoms may be discharged in a rigid cervical collar with outpatient follow-up and an MRI if the pain doesn't go away.
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