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  4. Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Cureus, 2024 · DOI: 10.7759/cureus.52077 · Published: January 11, 2024

NeurologyMedical ImagingRehabilitation

Simple Explanation

Spinal cord injury without radiographic abnormality (SCIWORA) is a condition where the spinal cord is damaged during a traumatic event, but standard imaging like X-rays doesn't show any issues. A more specific term, spinal cord injury without neuroimaging abnormality (SCIWNA), is used when even advanced imaging like MRI doesn't reveal any changes. This case report discusses a rare instance of SCIWNA in a 52-year-old woman after a road accident, highlighting the importance of thorough physical evaluation and rehabilitation.

Study Duration
Not specified
Participants
One 52-year-old woman
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    The patient presented with tetraplegia (AIS D) at C4, showing subtle improvements during inpatient care.
  • 2
    A tailored rehabilitation program involving a multidisciplinary team resulted in notable improvements in neuromotor function, gait, and activities of daily living.
  • 3
    Imaging studies, including MRI and CT scans, showed no spinal cord sign changes, fractures, or spinal cord compression, leading to the SCIWNA diagnosis.

Research Summary

This case report describes a rare instance of adult spinal cord injury without neuroimaging abnormality (SCIWNA) following a road accident in a 52-year-old woman, emphasizing the clinical nuances and management challenges associated with this condition. The patient presented with tetraplegia (American Spinal Injury Association Impairment Scale D) with a neurological injury level at C4, exhibiting subtle improvements during inpatient care. This rare case of SCIWNA underscores the diagnostic complexity when clinical spinal cord injury contrasts with normal neuroimaging.

Practical Implications

Diagnostic Awareness

Highlights the importance of considering SCIWNA in adults presenting with spinal cord injury symptoms despite normal neuroimaging.

Individualized Treatment

Emphasizes the need for individualized rehabilitation strategies tailored to patient-specific needs in the absence of a standardized management protocol.

Further Research

Warrants further research and consensus-building among healthcare professionals to improve the diagnosis and management of SCIWNA in adults.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of a definitive treatment protocol for SCIWNA.
  • 3
    Diagnostic challenges due to the evolving understanding of SCIWORA/SCIWNA.

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