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Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents

STUDY DESIGN: Retrospective analysis. OBJECTIVE: The SCIWORA Syndrome (Spinal Cord Injury Without Radiographic Abnormalities) is a rare but potentially severe injury with a peak in childhood and adolescence. With a better understanding of injury patterns and advances in MRI, there is ongoing discuss...

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Autores principales: Freigang, Viola, Butz, Katja, Seebauer, Caroline Theresa, Karnosky, Julia, Lang, Siegmund, Alt, Volker, Baumann, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210218/
https://www.ncbi.nlm.nih.gov/pubmed/33406912
http://dx.doi.org/10.1177/2192568220979131
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author Freigang, Viola
Butz, Katja
Seebauer, Caroline Theresa
Karnosky, Julia
Lang, Siegmund
Alt, Volker
Baumann, Florian
author_facet Freigang, Viola
Butz, Katja
Seebauer, Caroline Theresa
Karnosky, Julia
Lang, Siegmund
Alt, Volker
Baumann, Florian
author_sort Freigang, Viola
collection PubMed
description STUDY DESIGN: Retrospective analysis. OBJECTIVE: The SCIWORA Syndrome (Spinal Cord Injury Without Radiographic Abnormalities) is a rare but potentially severe injury with a peak in childhood and adolescence. With a better understanding of injury patterns and advances in MRI, there is ongoing discussion regarding the “Real SCIWORA” syndrome, a clinical picture of neurologic deficits on clinical examination but absence of radiographic pathologies even on MRI. The purpose of this study was to evaluate mid-term clinical outcome and the psychological impact of the “Real SCIWORA.” METHODS: In this retrospective analysis, we evaluated 32 patients treated for “Real SCIWORA” between 2007-2019. Inclusion criteria were: neurologic deficit after trauma, no other cerebral or skeletal injury and a lack of pathological findings in spinal MRI. All patients were followed until complete recovery from initial symptoms. 25/32 patients were re-evaluated after 6.9 years (1-14 years) using the Oswestry Disability Index, the Frankel Score, the EQ-5D score, and the Breslau Short Screening Scale for PTSD. RESULTS: Initial neurologic presentation ranged from Frankel Grade A-D. All patients recovered neurologically during 1-13 days to a Frankel Grade E. The analysis of HR-QoL revealed no difference between the cohort of SCIWORA patients and the German population norm, Oswestry Disability Index showed only minimal disabilities. 4/25 patients showed signs of PTSD. CONCLUSIONS: The “Real SCIWORA” syndrome is a diagnosis per exclusionem requiring a full spinal MRI to ensure exclusion of structural and potentially serious reasons of the neurologic impairment. Further clinical re-evaluation, psychological support seems to be essential. LEVEL OF EVIDENCE: IV—retrospective study.
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spelling pubmed-92102182022-06-22 Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents Freigang, Viola Butz, Katja Seebauer, Caroline Theresa Karnosky, Julia Lang, Siegmund Alt, Volker Baumann, Florian Global Spine J Original Articles STUDY DESIGN: Retrospective analysis. OBJECTIVE: The SCIWORA Syndrome (Spinal Cord Injury Without Radiographic Abnormalities) is a rare but potentially severe injury with a peak in childhood and adolescence. With a better understanding of injury patterns and advances in MRI, there is ongoing discussion regarding the “Real SCIWORA” syndrome, a clinical picture of neurologic deficits on clinical examination but absence of radiographic pathologies even on MRI. The purpose of this study was to evaluate mid-term clinical outcome and the psychological impact of the “Real SCIWORA.” METHODS: In this retrospective analysis, we evaluated 32 patients treated for “Real SCIWORA” between 2007-2019. Inclusion criteria were: neurologic deficit after trauma, no other cerebral or skeletal injury and a lack of pathological findings in spinal MRI. All patients were followed until complete recovery from initial symptoms. 25/32 patients were re-evaluated after 6.9 years (1-14 years) using the Oswestry Disability Index, the Frankel Score, the EQ-5D score, and the Breslau Short Screening Scale for PTSD. RESULTS: Initial neurologic presentation ranged from Frankel Grade A-D. All patients recovered neurologically during 1-13 days to a Frankel Grade E. The analysis of HR-QoL revealed no difference between the cohort of SCIWORA patients and the German population norm, Oswestry Disability Index showed only minimal disabilities. 4/25 patients showed signs of PTSD. CONCLUSIONS: The “Real SCIWORA” syndrome is a diagnosis per exclusionem requiring a full spinal MRI to ensure exclusion of structural and potentially serious reasons of the neurologic impairment. Further clinical re-evaluation, psychological support seems to be essential. LEVEL OF EVIDENCE: IV—retrospective study. SAGE Publications 2021-01-07 2022-07 /pmc/articles/PMC9210218/ /pubmed/33406912 http://dx.doi.org/10.1177/2192568220979131 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Freigang, Viola
Butz, Katja
Seebauer, Caroline Theresa
Karnosky, Julia
Lang, Siegmund
Alt, Volker
Baumann, Florian
Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title_full Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title_fullStr Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title_full_unstemmed Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title_short Management and Mid-Term Outcome After “Real SCIWORA” in Children and Adolescents
title_sort management and mid-term outcome after “real sciwora” in children and adolescents
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210218/
https://www.ncbi.nlm.nih.gov/pubmed/33406912
http://dx.doi.org/10.1177/2192568220979131
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