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Clinical Pediatrics, Vol. 35, No. 3, 119-124 (1996)
DOI: 10.1177/000992289603500302

SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) in Infants and Children

Vesna Martich Kriss

Department of Diagnostic Radiology, University of kentucky Medical Center, Department of Pediatrics, University of Kentucky Medical Center

Timothy C. Kriss

Department of Surgery (Division of Neurosurgery), University of Kentucky Medical Center, Lexington, Kentucky

We review the biomechanics of the pediatric cervical spine and the clinical findings that pertain to SCIWORA (spinal cord injury without radiographic abnormality) in order to provide a more thorough understanding of this pediatric phenomenon of closed spinal trauma with significant neurologic sequelae but without bony injury. The unique hypermobility and ligamentous laxity of the pediatric bony cervical and thoracic spine predispose to a SCIWORA-type injury. In SCIWORA, the unusually elastic biomechanics of the pediatric bony spine allow deformation of the musculoskeletal structures beyond physiologic extremes, permitting direct cord trauma followed by spontaneous reduction of the bony spine. Potential mechanisms of the SCIWORA include hyperextension/ flexion, longitudinal distraction, and ischemic injury of the spinal cord.


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J. D. Eubanks, A. Gilmore, S. Bess, and D. R. Cooperman
Clearing the pediatric cervical spine following injury.
J. Am. Acad. Ortho. Surg., September 1, 2006; 14(9): 552 - 564.
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