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

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