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    Presentasi Spine Sciwora

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    Rifky Hardian
    The document discusses spinal cord injury without radiological abnormalities (SCIWORA). It was first described in 1982 and mainly affects the pediatric population. SCIWORA can account for 10-20% of spinal cord injuries in children. While x-rays and CT scans appear normal, MRI is needed to detect injuries like disc space injuries or hematomas. SCIWORA can result from traction, direct or indirect compression, or vascular injury to the spinal cord. Patients may present with transient or permanent neurological deficits following minor trauma.

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    Presentasi Spine Sciwora

    Uploaded by

    Rifky Hardian
    70 views24 pages
    The document discusses spinal cord injury without radiological abnormalities (SCIWORA). It was first described in 1982 and mainly affects the pediatric population. SCIWORA can account for 10-20% of spinal cord injuries in children. While x-rays and CT scans appear normal, MRI is needed to detect injuries like disc space injuries or hematomas. SCIWORA can result from traction, direct or indirect compression, or vascular injury to the spinal cord. Patients may present with transient or permanent neurological deficits following minor trauma.

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    The document discusses spinal cord injury without radiological abnormalities (SCIWORA). It was first described in 1982 and mainly affects the pediatric population. SCIWORA can account for 10-20% of spinal cord injuries in children. While x-rays and CT scans appear normal, MRI is needed to detect injuries like disc space injuries or hematomas. SCIWORA can result from traction, direct or indirect compression, or vascular injury to the spinal cord. Patients may present with transient or permanent neurological deficits following minor trauma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    70 views24 pages

    Presentasi Spine Sciwora

    Uploaded by

    Rifky Hardian
    The document discusses spinal cord injury without radiological abnormalities (SCIWORA). It was first described in 1982 and mainly affects the pediatric population. SCIWORA can account for 10-20% of spinal cord injuries in children. While x-rays and CT scans appear normal, MRI is needed to detect injuries like disc space injuries or hematomas. SCIWORA can result from traction, direct or indirect compression, or vascular injury to the spinal cord. Patients may present with transient or permanent neurological deficits following minor trauma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    SCIWORA

    CK Cheang
    HRPB
    Ipoh
    SCIWORA

     S- Spinal

     C- Cord

     I- Injury

     WO- Without

     R- Radiological

     A- Anomalies
    SCIWORA

     First describe by Pang and Wilberger in 1982

     Mainly in the pediatric age group

     Era without MRI

     They describe group of children with clinical spinal cord injury


    but xray and CT scan was normal

     10 to 20% of all spinal cord injuries in children

     In elderly small percentage of pt also presented with SCIWORA


    Mechanism of Injury

     Traction

     Direct compression

     Indirect compression

     Vascular injury
    Traction

     In children ligaments are weaker then bone

     Adults are reverse

     The ligaments are elastic

     Able to distract up to 2x length before rupture

     Spinal cord is resistant to traction

     Once traction occurs permanent spinal cord injury occurs


    Compression

     Permanent

     Occult fractures

     Permanent prolapsed disc

     Hematoma
    Compression

     Transient

     Yellow ligament bulging secondary to hyperextension

     Transient subluxation

     Transient disc bulge


    Indirect Compression

     Direct kinetic energy transmitted to the cord

     Cord concussion
    Vascular Injury

     Vascular occlusion

     Dissecting injury of vessels

     Hypotension
    Presentation

     Important to remember

     10% of head injury associated with cervical injury

     Must have high level of suspicions

     Any history of transient neurological deficit related to


    cervical injury are SCIWORA until proven otherwise

     Xray or CT scan normal does not means no cervical injury


    Presentation

     Classical presentation

     Transient neurological deficit

     Later minor trauma with severe deficit

     However pt may present with with from transient deficit


    to complete neurology

     Diagnosis is difficult

     Your eyes will see what you know


    Investigations

     SCIWORA

     Xray and CT scan essentially normal

     MRI is the only important tools of investigation

     Any pt suspected SCIWORA needs urgent MRI

     Look for either direct or indirect signs on MRI


    Investigation

     Disc space injury

     Inter spinous process hematoma

     Anterior vertebrae space swelling or hematoma

     Bone oedema

     All these you will see in MRI

     If you don’t look for it you won’t see it


    Management

     As any spine injury

     Immobilization

     Surgical decompression for permanent compression

     Support therapy

     Fixation is difficult in children

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