SCIWORA in MRI era

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. (c) 2008 Elsevier B.V. All rights reserved