Universität zu Köln

Boese, Christoph Kolja, Oppermann, Johannes, Siewe, Jan, Eysel, Peer, Scheyerer, Max Joseph and Lechler, Philipp (2015). Spinal cord injury without radiologic abnormality in children: A systematic review and meta-analysis. J. Trauma Acute Care Surg., 78 (4). S. 874 - 883. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 2163-0763

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Abstract

BACKGROUND: Spinal cord injury in children is associated with severe morbidity and immense socioeconomic burden. In spinal cord injury without radiologic abnormalities (SCIWORA), magnetic resonance imaging (MRI) can detect intramedullary or extramedullary pathologies or show absence of neuroimaging abnormalities. However, the prognostic and therapeutic consequences of specific MRI patterns are unclear. A comprehensive systematic literature search was performed to examine patient characteristics and imaging patterns of pediatric SCIWORA and to evaluate the prognostic value of a MRI-based classification system. METHODS: MEDLINE, Cochrane Central Register of Controlled Trials, and Google Scholar were searched for studies on SCIWORA in children. Inclusion criteria were (1) traumatic spinal cord injury with acute neurologic deficit, (2) absence of fractures and/or dislocations of the spine, and (3) an immature skeleton or age of less than 18 years. MRI patterns and clinical course were correlated. RESULTS: Forty articles reporting 114 patients were identified. At admission, neurologic deficit assessed by the American Spinal Injury Association impairment scale was A in 28%, B in 17%, C in 31%, and D in 25%. At final follow-up, these were 19%, 6%, 10%, and 16%, respectively. In 43%, no MRI abnormalities (Type I) were detected, and 57% exhibited abnormal scan results (Type II): 6% revealed extraneural (Type IIa), 38% intraneural (Type IIb), and 13% combined abnormalities (Type IIc). At admission and follow-up, American Spinal Injury Association impairment scale differed significantly between the imaging types. CONCLUSION: This systematic review emphasizes the prognostic value of spinal MRI for children with SCIWORA. It highlights the role of the MRI classification system in improving the comparability and interpretability. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boese, Christoph Kolja UNSPECIFIED UNSPECIFIED UNSPECIFIED Oppermann, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheyerer, Max Joseph UNSPECIFIED UNSPECIFIED UNSPECIFIED Lechler, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-408499
DOI:	10.1097/TA.0000000000000579
Journal or Publication Title:	J. Trauma Acute Care Surg.
Volume:	78
Number:	4
Page Range:	S. 874 - 883
Date:	2015
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	2163-0763
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIOGRAPHIC ABNORMALITY; THORACIC SCIWORA; TRAUMA; ADULTS; RECOVERY; ABSENCE; MRI Multiple languages Critical Care Medicine; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40849