Bonfanti Laura, Donelli Valentina, Lunian Marco, Cerasti Davide, Cobianchi Francesca, Cervellin Gianfranco
Academic Hospital of Parma, Italy.
Acta Biomed. 2019 Jan 15;89(4):593-598. doi: 10.23750/abm.v89i4.7532.
The term SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) indicates a clinically appreciable post-traumatic myelopathy in the absence of spinal column findings on radiographs and/or computed tomography (CT), but with pathologic findings at magnetic resonance imaging (MRI) in approximately two-thirds of cases. Affecting mainly children younger than 8 years, SCIWORA has been, however, also described in adult patients, but, due to the uncertainty of classification and frequent co-morbidity, the term "adult SCIWORA" has generated controversy, and some debate is still active. In this article, we report two different cases of adult SCIWORA involving cervical spinal cord, characterized by distinct and peculiar clinical features. A literature review and some clinical suggestions are also reported, mainly focused on the importance of a high level of suspicion in order to achieve a timely diagnosis and optimize the management and, consequently, the outcome of these trauma patients.
“无放射学异常的脊髓损伤（SCIWORA）”这一术语指的是在X线片和/或计算机断层扫描（CT）上没有脊柱损伤表现，但在磁共振成像（MRI）上约三分之二的病例有病理学表现的创伤后可临床察觉的脊髓病。SCIWORA主要影响8岁以下儿童，不过，成人患者中也有相关报道，但由于分类的不确定性和频繁的合并症，“成人SCIWORA”这一术语引发了争议，目前仍有一些争论。在本文中，我们报告了两例涉及颈段脊髓的成人SCIWORA不同病例，其具有独特的临床特征。还报告了文献综述及一些临床建议，主要聚焦于高度怀疑的重要性，以便及时诊断并优化这些创伤患者的治疗及最终结果。
