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INNOSC Theranostics

and Pharmacological Sciences

REVIEW ARTICLE
Guidelines for treating spinal cord injury without

radiological abnormalities in children

Ruba Altahla , Jamal Alshorman , and Xu Tao *
1
1
2
1 Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
2 Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China

Abstract
Spinal cord injury without radiological abnormality (SCIWORA) is a rare condition
that predominantly affects children. The enigmatic nature of SCIWORA poses
significant challenges in terms of diagnosis, treatment, and achieving full recovery.
Various factors, such as different injury mechanisms, delayed symptom onset,
normal magnetic resonance imaging findings in certain cases, and complex
management decisions, contribute to the challenges of dealing with SCIWORA.
Attaining a significant outcome and complete recovery through a single-treatment
approach is difficult. Therefore, a multifaceted treatment strategy is proposed to
yield more favorable results. This paper comprehensively addresses the assessment
and management, examination and diagnosis procedures, treatment methods,
rehabilitation techniques, and potential complications associated with SCIWORA
*Corresponding author: in children. The paper provides therapeutic guidance for physicians and medical
Xu Tao
(i202122089@hust.edu.cn) staff, with the aim of enhancing survival rates and improving recovery outcomes.
Moreover, it offers suggestions for restoring neurological functions in pediatric
Citation: Altahla R, Alshorman J and patients suffering from SCIWORA.
Tao X, 2024, Guidelines for treating
spinal cord injury without radiological
abnormalities in children. INNOSC
Theranostics and Pharmacological Keywords: Spinal cord injury without radiological abnormality; Pediatrics; Magnetic
Sciences, 7(1): 1386. resonance imaging; Surgery; Therapeutic treatment; Rehabilitation
https://doi.org/10.36922/itps.1386
Received: July 27, 2023
Accepted: September 6, 2023
1. Introduction
Published Online: October 13,
2023 The original description of spinal cord injury without radiological abnormality
(SCIWORA) was first published in 1982 . SCIWORA is a rare disease that primarily
[1]
Copyright: © 2023 Author(s).
This is an Open-Access article affects children but also occurs in adults, with a higher prevalence in children due to
distributed under the terms of the anatomical differences and the mechanism of injury (MOI). In children outside of China,
Creative Commons Attribution 75% of spinal cord injuries (SCIs) are attributed to violent trauma, such as sports-related
License, permitting distribution,
and reproduction in any medium, injuries, child abuse, motor vehicle accidents, falls, and diving accidents. Conversely, in
provided the original work is China, 50% of cases result from nonviolent trauma during dance training, particularly
properly cited. related to backbend movements . The underlying mechanism of SCIWORA in children
[2]
[3]
Publisher’s Note: AccScience is complicated and differs from that in adults . The biomechanics of the pediatric spine
Publishing remains neutral with plays an important role in this condition. Compared to adults, the higher elasticity of
regard to jurisdictional claims in
published maps and institutional the children’s spine increases the risk of developing SCIWORA. Factors such as flexion,
affiliations. hyperextension, longitudinal distraction, and ischemia can contribute to SCIWORA in

Volume 7 Issue 1 (2024) 1 https://doi.org/10.36922/itps.1386