Köksal V, Demirel C, Van M, Tomakin F, Engin R. A Rare Case of Adult Thoracic SCIWORA: Complete Cord Transection Without Vertebral Injury. Iran J Neurosurg 2025; 11
URL:
http://irjns.org/article-1-496-en.html
1- Department of Neurosurgery, Faculty of Medicine, Samsun Training and Research Hospital, Samsun University, Samsun, Türkey.
Abstract: (8 Views)
Background and Importance: Spinal cord injury without radiographic abnormality (SCIWORA) is predominantly reported in pediatric populations, especially involving the cervical spine. In adults, particularly in the thoracic region, such injuries are exceedingly rare due to the biomechanical rigidity of the thoracic vertebrae. This case report presents an adult patient with a complete spinal cord transection at the T7–T8 level in the absence of any vertebral fracture or dislocation.
Case Presentation: A 25-year-old male was admitted to the intensive care unit following a highenergy motor vehicle accident. Although the initial computed tomography (CT) of the thoracic spine showed no signs of vertebral injury, the patient developed complete paraplegia upon regaining consciousness. Magnetic resonance imaging (MRI) revealed a full-thickness transection of the spinal cord at the T7–T8 level. No surgical intervention was indicated due to the absence of compressive or unstable elements.
Conclusion: Adult thoracic SCIWORA is an exceptionally rare clinical entity. In cases of severe neurological deficit with negative radiographs and CT scans, a prompt MRI is crucial for diagnosis. This case highlights the need for refined classification systems that incorporate MRI findings and biomechanical assessments to characterize such presentations better and inform clinical management.
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● Complete thoracic cord transection without fracture
● MRI showed full spinal cord transection at T7–T8 with no vertebral injury—an extremely rare adult SCIWORA case.
● MRI is essential despite normal CT/X-ray Early MRI is critical for diagnosing unexplained neurological deficits when CT and radiographs are negative.
● Current SCIWORA classifications are insufficient The case highlights the need for updated systems, including MRI findings and biomechanical stability in adults.
Type of Study:
Case report |
Subject:
Spine