Spinal cord injury without radiographic abnormality with diffuse idiopathic skeletal hyperostosis: A case report

International Journal of Surgery Case Reports, 2024 · DOI: https://doi.org/10.1016/j.ijscr.2024.109654 · Published: April 20, 2024

Spinal Cord Injury Orthopedics Research Methodology & Design

Simple Explanation

Spinal cord injury without radiographic abnormality (SCIWORA) happens when the spinal cord is injured without showing fractures or dislocations on imaging. This case report describes a 70-year-old man with SCIWORA and Diffuse Idiopathic Skeletal Hyperostosis (DISH), a condition causing hardening of ligaments and bone spurs in the spine. The patient underwent surgery (anterior cervical discectomy and fusion - ACDF) to relieve pressure on the spinal cord, leading to improved symptoms and recovery.

Study Duration

3-month follow-up

Participants

A 70-year-old male patient

Evidence Level

Level 4: Case Report

Key Findings

1
Adult SCIWORA patients with segmental instability should be treated surgically, even if the optimal time for surgery has passed, to avoid secondary injury.
2
Anterior cervical discectomy and fusion (ACDF) is an effective surgical procedure for SCIWORA by directly removing compression from the anterior aspect of the spinal cord.
3
Titanium plates combined with self-stabilizing fusions provide reliable immediate stabilization and can be one of the internal fixation modalities for SCIWORA patients.

Research Summary

This case report presents the successful surgical management of a 70-year-old male patient with SCIWORA combined with DISH who presented with quadriplegia and incontinence. The patient underwent anterior cervical discectomy and fusion (ACDF) with titanium plate fixation, resulting in significant improvement in neurological function and overall symptoms. The authors conclude that aggressive surgical treatment is warranted in adult SCIWORA patients, even when surgery is delayed, particularly in the presence of segmental instability and the risk of secondary injury.

Practical Implications

Surgical Intervention for SCIWORA

Adult SCIWORA patients, especially those with instability, benefit from aggressive surgical intervention to prevent secondary injuries, even if delayed.

ACDF Effectiveness

Anterior cervical discectomy and fusion (ACDF) is a viable surgical option for SCIWORA, effectively decompressing the spinal cord.

Internal Fixation Modalities

Titanium plates combined with self-stabilizing fusions offer reliable immediate stabilization for SCIWORA patients undergoing surgical treatment.

Spinal cord injury without radiographic abnormality with diffuse idiopathic skeletal hyperostosis: A case report

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Intervention for SCIWORA

ACDF Effectiveness

Internal Fixation Modalities

Study Limitations

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Spinal cord injury without radiographic abnormality with diffuse idiopathic skeletal hyperostosis: A case report

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Intervention for SCIWORA

ACDF Effectiveness

Internal Fixation Modalities

Study Limitations

Your Feedback

Was this summary helpful?