Spinal Cord Injury Without Radiographic Abnormality
Publication Date: March 1, 2013
Last Updated: March 14, 2022
RECOMMENDATIONS
Note: All recommendations are Level III.
Diagnosis
Magnetic resonance imaging of the region of suspected neurological injury is recommended in a patient with spinal cord injury without radiographic abnormality (SCIWORA).
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Radiographic screening of the entire spinal column is recommended.
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Assessment of spinal stability in a SCIWORA patient is recommended with flexion-extension radiographs in the acute setting and at late follow-up, even in the presence of a magnetic resonance imaging negative for extraneural injury.
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Neither spinal angiography nor myelography is recommended in the evaluation of patients with SCIWORA.
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Treatment
External immobilization of the spinal segment of injury is recommended for up to 12 weeks.
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Early discontinuation of external immobilization is recommended for patients who become asymptomatic and in whom spinal stability is confirmed with flexion and extension radiographs.
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Avoidance of “high-risk” activities for up to 6 months following SCIWORA is recommended.
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Recommendation Grading
Overview
Title
Spinal Cord Injury Without Radiographic Abnormality
Authoring Organization
Congress of Neurological Surgeons
Publication Month/Year
March 1, 2013
Last Updated Month/Year
January 10, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Child, Infant
Health Care Settings
Ambulatory, Childcare center, Emergency care, Hospital, Operating and recovery room
Intended Users
Social worker, radiology technologist, physician, nurse midwife, nurse, nurse practitioner, physician assistant
Scope
Management, Treatment
Diseases/Conditions (MeSH)
D013119 - Spinal Cord Injuries
Keywords
spinal cord injury, Radiograpic abnormality, SCIWORA, spinal angiography, myelography