Special Consideration: SCIWORA

Spinal Cord Injury Without Obvious Radiological Abnormality (SCIWORA) refers to the situation that may arise in children in which the initial radiographs are normal despite clinical evidence of cord injury [12].

The anatomical and physiological features outlined earlier predispose the developing spine to significant movement without causing bony injury. This may lead either to ischaemic cord injury or direct traction injury to the cord.

SCIWORA can occur at any age but is most common in younger children [13-15].

If SCIWORA is suspected, an MRI of the cervical spine may demonstrate the underlying injury