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J Korean Soc Emerg Med > Volume 15(5); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(5): 311-316.
The Role of MRI in Spinal Cord Injury Without Radiographic Abnormality
Kyu Seok Kim, Jae Hyuk Lee, Woo jeong Kim, Sang Do Shin, Sung Koo Jung, Joong Eui Rhee, Gil Joon Suh, Yeo Kyu Youn
Department of Emergency Medicine, Seoul National University, College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
ABSTRACT
PURPOSE:
Spinal cord injury without radiographic abnormality (SCIWORA) usually has been documented in pediatric patients. We report 8 cases of SCIWORA in adult and evaluate the diagnostic and prognostic value of MRI in SCIWORA.
METHODS:
We retrospectively studied adult patients who presented to the emergency room of a tertiary army hospital with SCIWORA, from Jan. 2001 to Dec. 2002. We reviewed the patient 's medical records, plain films, CT and MRI findings.
RESULTS:
There were 8 patients of SCIWORA during 2 years. Major mechanisms of injuries were sports-related injury (62.5%) and fall (25%). They presented with central cord syndrome (62.5%), Brown-Sequard syndrome (12.5%), monoparesis (12.5%), and sensory symptom only (12.5%). All patients were checked with MRI and five patients (62.5%) showed abnormal MRI findings including spinal cord hemorrhage, edema, and disc herniation. All patients received megadose methylprednisolone therapy, and three underwent operations. Patients, who had been recovering at the time of admission to our ER, had normal MRI findings, and all patients with normal MRI findings had full neurological recovery within 3 days. Only two patients had neurological sequelae, and their MRI findings were spinal cord hemorrhage and herniated disc with cord compression, respectively.
CONCLUSION:
SCIWORA in adults, even though rare, exists, and MR imaging findings determine treatment plan and neurological outcome of patients.
Key words: Spinal cord injury, Radiography, MRI
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