Ann Rehabil Med.  2012 Dec;36(6):871-875.

Delayed Onset of Thoracic SCIWORA in Adults

• Park MC
• Bok SK
• Lee SJ
• Ahn DH
• Lee YJ

Abstract

Spinal cord injury (SCI) without radiographic abnormality (SCIWORA) is estimated to account for 1-9% of the occurrence of SCI. Of these, cervical SCIWORA in children is common, but thoracic SCIWORA delayed onset in adult is much less common. We experienced a case of 38-years old male patient with lower extremity weakness; he had fallen down a week earlier before the investigation. At the time of admission, motor grade was 4 with voiding incontinence and ambulated with cane. He presented progressive weakness from G4 to G3 and hypoesthesia was below T8 dermatome and ambulated with wheelchair. Whole spine and lumbar MRI findings showed no abnormality and electrodiagnostic findings showed normal NCS, however, abnormal SEP on both the tibial nerves. After steroid therapy and proper rehabilitation program for 2 weeks, lower extremity strength was improved from G4 to G3, voiding was continent, and ambulation reached cane gait.

Keyword

Spinal cord injury; Thoracic spine; Delayed onset

MeSH Terms

Adult
Canes
Child
Gait
Humans
Hypesthesia
Lower Extremity
Male
Spinal Cord Injuries
Spine
Tibial Nerve
Walking
Wheelchairs

Figure

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  Fig. 1 Whole Spine MRI, HD#1. Anterior wedging at T12 and L1, disc degeneration with annular tearing at L1-2.

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  Fig. 2 MR Brain, HD#13. No abnormal signal changes.

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  Fig. 3 MR thoracic, HD#17. No abnormal findings of a thoracic lesion (official reading), but suspicious of a signal change.

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