Yucesoy Kemal, Yuksel K Zafer
Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Clin Neurol Neurosurg. 2008 May;110(5):429-33. doi: 10.1016/j.clineuro.2008.02.004. Epub 2008 Mar 19.
The aim of this report is to discuss the use of the term 'Spinal Cord Injury Without Radiographic Abnormality' (SCIWORA) in the medical literature ever since MRI became commonly employed in the diagnosis of spinal cord injuries. Using the PubMed database and the keywords 'SCIWORA and MRI', we found 30 published articles in the English-language literature. Incidence, clinical and radiological data, and MRI findings were evaluated in all articles, which included one meta-analysis, two reviews, 10 case series, and 17 case reports. The incidence of SCIWORA among children was found to be between 3.3% and 32.0%. This wide range was directly related to patients' age, authors' specialty, and utilization of MRI. After MRI became commonly used for spinal injuries, the term has taken on an ambiguous meaning in the literature. In our opinion, if any pathology is detected on MRI with or without radiographic abnormality, the patients should not be classed, as SCIWORA and 'real-SCIWORA' should be determined as 'Spinal Cord Injury Without Neuroimaging Abnormality' in cases with normal MRI.
本报告旨在探讨自MRI广泛应用于脊髓损伤诊断以来,医学文献中“无放射学异常的脊髓损伤”(SCIWORA)这一术语的使用情况。通过PubMed数据库并使用关键词“SCIWORA和MRI”,我们在英文文献中找到了30篇已发表的文章。对所有文章中的发病率、临床和放射学数据以及MRI表现进行了评估,其中包括1篇荟萃分析、2篇综述、10篇病例系列和17篇病例报告。儿童中SCIWORA的发病率在3.3%至32.0%之间。这一广泛范围与患者年龄、作者专业以及MRI的使用直接相关。在MRI广泛用于脊柱损伤后,该术语在文献中具有了模糊的含义。我们认为,如果在MRI上检测到任何病理改变,无论有无放射学异常,患者都不应归类为SCIWORA,而在MRI正常的情况下,“真正的SCIWORA”应被确定为“无神经影像学异常的脊髓损伤”。