SCIWORA in Adults: Clinical and Radiological Discordance.

SCIWORA in Adults: Clinical and Radiological Discordance.

World Neurosurg. 2018 Mar 31;:

Authors: Asan Z

Abstract
OBJECTIVE: SCIWORA cases show different clinical prognostic courses independent of radiological findings. The fact that the cases could not be evaluated by a specific terminological standard has led to the emergence of the real SCIWORA definition. In this study, clinical progressions of 11 patients diagnosed with SCIWORA were analyzed, and terminological differences were discussed.
MATERIALS AND METHODS: The clinical findings of 11 adults that were followed-up with a diagnosis of SCIWORA at the time of diagnosis and in the long term were analyzed according to the ASIA classification. The presence of a correlation between radiological findings from the early and late periods and the clinical findings was investigated. High-dose methylprednisolone treatment was administered to all newly diagnosed cases in the early period, and the clinical response was observed. Clinical, prognostic, and radiological comparisons were made to SCIWORA cases reported in the literature.
RESULTS: 7 cases received a diagnosis of cervical SCIWORA, and 4 cases thoracal SCIWORA. Neurological findings at the time of diagnosis and those from the early and late period vary independently of radiological findings. In the cases where a considerable neurological recovery was not observed within the first three days, significant levels of healing were also not seen in the later period. In the cases where neurological recovery was seen, improvement in sphincter function, sensory and motor deficits were observed respectively.
CONCLUSION: In cases diagnosed with SCIWORA, the early neurological response is the determinant factor for prognosis. Clinical findings and the prognosis demonstrate no correlation with radiological findings.

PMID: 29614362 [PubMed - as supplied by publisher]

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