Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 4
Cervicothoracic Spinal Cord Injury Without Radiographic Evidence of Trauma (SCIWORET) in an Adult: A Case Report
Sibel Ünsal Delialioğlu 1 ,Canan Çulha 2 ,Zuhal Yiğit 3 ,Önder Delialioğlu 4
1 Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
2 Clinic of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
3 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 3. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
4 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi 4. Ortopedi Kliniği, Ankara

Spinal cord injury without a radiographic evidence of trauma (SCIWORA) is more frequently encountered in the pediatric age group, especially in cervical spinal cord. The case presented here has a rare picture of this type observed in adults rarely. The case developed a neurological deficit as a result of an accident involving a heavy substance fall on his neck and back junction. Conventional graphs, cranial and cervical tomographies taken in the acute period did not reveal any pathology that could explain the existing clinical picture. Myelomalacia was determined at C7-T1 level following cervicothoracic spinal magnetic resonance imaging (MRI). Based on his existing neurological picture (ASIA B) and MRI findings, the patient was given a diagnosis of SCIWORET (Spinal Cord Injury Without Radiographic Evidence of Trauma). Following the rehabilitation program, the patient’s neurological level improved to ASIA D level. He became dischargeable with a left knee-ankle-foot orthosis and a walker support.  SCIWORET should be born in mind also in adults with a neurological deficit but without any bone and ligamentous damage determined, and MRI should be utilized in the diagnosis. Keeping in mind that the prognosis is good, early rehabilitation program should be started.

Keywords : SCIWORET, spinal cord injury, rehabilitatio