SCIWOR in Children with Associated Head Injury: Role of MRI

Abstract

Confirmation of spinal cord injury is difficult in comatosed or obtunded patients. This becomes even more difficult in children where spinal cord injury can occur without obvious vertebral column disruption. Therefore an advanced diagnostic method for the evaluation of suspected spinal cord injury is desirable.  We conducted a prospective study in which magnetic Resonance Imaging was used to assess posttraumatic spinal cord injury in the comatosed or obtunded paediatric patients. Early limited (sagittal T1-T2 weighted) MR imaging was performed to delineate and differentiate the diagnosis of SCIWORA in seven children with head injury and possible spinal injuries. Patients were excluded from the study if they had an obvious spine injury (bony and /or ligamentous) identified on the initial radiographic studies. Obtaining early sagittal T1-T4 weighted MR Imaging is a safe strategy for the identification of this non-apparent spinal cord injury in obtunded or comatose trauma paediatric patients. In all seven patients except one the MRI findings correlated well with our clinical findings.