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"Stanislav Kaprovoy"

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Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):797-808.   Published online December 31, 2020
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Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):797-808.   Published online December 31, 2020
Close
Cervical trauma in children have variations from the adults mainly due to anatomic differences. An optimal diagnostic and treatment strategy is critical, particularly when there is a lack of standardized protocols for the management of such cases. This review paper examines the diagnostic and treatment options of pediatric cervical trauma and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA). A literature search for the last 10 years were conducted using key words. Case reports, experimental studies, papers other than English language were excluded. Up-to-date information on pediatric cervical trauma and SCIWORA were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of WFNS Spine Committee. The statements were voted and reached a consensus using Delphi method. This review reflects different aspects of contemporary pediatric cervical trauma decision-making and treatment, and SCIWORA. The mainstay of SCIWORA treatment is nonsurgical with immobilization, avoidance of risky activities. Prognosis generally depends on the initial neurological status and magnetic resonance imaging. Due to a significant discrepancy in the literature on diagnostic and management, future randomized controlled trials are needed to aid in generating standardized protocols.

Citations

Citations to this article as recorded by  Crossref logo
  • Nontraumatic ischemic spinal cord injury following vigorous exercise: a case report
    Afonso Sousa, Paula Kjöllerström, Amets Sagarribay, Jaime Pamplona, Joana Branco
    Emergency and Critical Care Medicine.2026; 6(1): 70.     CrossRef
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    Shadi Asadollahi, Parisa Arjmand, Arjun Chanmugam, Matthew Dattwyler, Caline Azzi, Mahla Radmard, David M. Yousem
    Radiology.2026;[Epub]     CrossRef
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    Susan Gorman, Laura Duthie
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    Michel Paul Johan Teuben, Anna Veenstra, Hans-Christoph Pape
    Journal of Trauma and Acute Care Surgery.2026; 100(6): 850.     CrossRef
  • Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation
    Qunya Qi, Ling Wang, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Xianglin Guo, Weimin Zheng, Xin Chen, Qian Chen, Fang Li, Jubao Du, Jie Lu, Nan Chen
    Spinal Cord.2025; 63(7): 342.     CrossRef
  • Magnetic resonance imaging in spinal cord injury without radiographic abnormalities in the spine in children
    Tolibdzhon A. Akhadov, Maxim V. Ublinskiy, Irina N. Novoselova, Olga V. Bozhko, Ilya A. Melnikov, Dmitriy M. Dmitrenko, Irina V. Ponina, Ekaterina S. Zaitseva, Elena V. Voronkova
    Russian Pediatric Journal.2025; 28(3): 189.     CrossRef
  • Pediatric Spinal Imaging
    Joshua K. Dodderer, Janine Amirault, Joyce Li
    Emergency Medicine Clinics of North America.2025; 43(4): 633.     CrossRef
  • Redefining Pediatric SCIWORA: A Systematic Review of the Literature on Clinical Patterns, Imaging Profiles, and Management Insights
    Davide Palombi, Marco Galeazzi, Paolo Brigato, Sergio De Salvatore, Timothée De Saint Denis, Luca Massimi, Gianpiero Tamburrini, Leonardo Oggiano
    Journal of Clinical Medicine.2025; 14(17): 6338.     CrossRef
  • Establishing an Australian pediatric spinal cord disorder register using consumer, health professional, and researcher perspectives
    Jamie Ellis, Erin Garner, Kate E. Webster, Susan Darzins, Mary P. Galea, Adam Scheinberg
    The Journal of Spinal Cord Medicine.2024; 47(4): 495.     CrossRef
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    Global Spine Journal.2024; 14(7): 1937.     CrossRef
  • SCIWORA. Una rara entidad clínica en la población pediátrica. Estudio ambispectivo
    L.M. Romero-Muñoz, M. Peral-Alarma, A. Barriga-Martín
    Revista Española de Cirugía Ortopédica y Traumatología.2024; 68(2): 151.     CrossRef
  • [Translated article] SCIWORA in children. A rare clinical entity: Ambispective study
    L.M. Romero-Muñoz, M. Peral-Alarma, A. Barriga-Martín
    Revista Española de Cirugía Ortopédica y Traumatología.2024; 68(2): T151.     CrossRef
  • Clinical characteristics analysis of pediatric spinal cord injury without radiological abnormality in China: a retrospective study
    Renfeng Liu, Qizhi Fan, Jingpeng He, Xin Wu, Wei Tan, Zuyun Yan, Weiguo Wang, Zhiyue Li, You-Wen Deng
    BMC Pediatrics.2024;[Epub]     CrossRef
  • Pediatric Trauma—Not Just Little Adults-Part 2: Differences in Radiographic Workup and Management
    Alicia C. Greene, Sara Pettey Sandifer, Melanie Shpigel, Shawn D. Safford
    Current Surgery Reports.2024; 12(7): 196.     CrossRef
  • Pediatric Trauma—Not Just Little Adults—Part 1: Differences in Physiology and Injury Patterns
    Alicia C. Greene, Melanie Shpigel, Sara Pettey Sandifer, Shawn D. Safford
    Current Surgery Reports.2024; 12(7): 186.     CrossRef
  • Paediatric Spinal Cord Injury: A Review of Current Management
    Chikolum Ejide, Soham Bandyopadhyay, Kokila Lakhoo
    Cureus.2024;[Epub]     CrossRef
  • Imaging Outcomes of MRI After CT in Pediatric Spinal Trauma: A Single-center Experience
    Aapo Sirén, Mikko Nyman, Johanna Syvänen, Kimmo Mattila, Jussi Hirvonen
    Journal of Pediatric Orthopaedics.2024; 44(10): e887.     CrossRef
  • SCIWORA (lesión de la médula espinal sin anormalidad radiográfica). Conceptos y revisión narrativa de la literatura
    José Rafael Calderón Varela, Luis Mario Hinojosa Martínez, Edgar Joaquín Cardeña Morales, Christian Armando Mantecón Domínguez, Andrés Villalvazo Barón
    Cirugía de Columna.2024; 2(3): 170.     CrossRef
  • Unstable C2-3 Posterior Ligamentous Injury in a Pediatric Patient with Successful Nonoperative Treatment
    Edward R. Floyd, Kyler A. Hardie, Arnold H. Menezes, Geoffrey F. Haft
    JBJS Case Connector.2024;[Epub]     CrossRef
  • Clinical characteristics and treatment of spinal cord injury in children and adolescents
    Jin-Zuo Wang, Ming Yang, Meng Meng, Zhong-Hai Li
    Chinese Journal of Traumatology.2023; 26(1): 8.     CrossRef
  • Cervical spine flexion-extension radiography versus magnetic resonance imaging in pediatric patients following blunt traumatic injury
    Jeff F Zhang, Janet Umenta, Adil Ali, Renee Reynolds, Phillip Benson Ham, Richard D Thomas, Ravi Piryani, Muhammad Izhar, Brian Wrotniak, Anil K Swayampakula
    Trauma Surgery & Acute Care Open.2023; 8(1): e001016.     CrossRef
  • A critical appraisal of clinical practice guidelines for diagnostic imaging in the spinal cord injury
    Bin Guan, Guoyu Li, Ruiyuan Zheng, Yuxuan Fan, Liang Yao, Lingxiao Chen, Shiqing Feng, Hengxing Zhou
    The Spine Journal.2023; 23(8): 1189.     CrossRef
  • A critical appraisal of clinical practice guidelines on surgical treatments for spinal cord injury
    Ruiyuan Zheng, Yuxuan Fan, Bin Guan, Runhan Fu, Liang Yao, Wei Wang, Guoyu Li, Yue Zhou, Lingxiao Chen, Shiqing Feng, Hengxing Zhou
    The Spine Journal.2023; 23(12): 1739.     CrossRef
  • Relationship of cervical soft tissue injury and surgical predication following pediatric cervical spinal trauma and its sequelae on long-term neurologic outcome
    Jasmine L. Hect, Michael M. McDowell, Daryl Fields, Stephanie Greene
    World Neurosurgery: X.2023; 20: 100235.     CrossRef
  • Delayed Surgical Treatment of Cervical Spine Injury in an Adolescent Patient
    D. A. Karpov, E. F. Shakurov, T. A. Farkhutdinov, L. A. Kulmanova, A. V. Antonov, E. V. Strepetkov
    Creative surgery and oncology.2023; 13(3): 260.     CrossRef
  • Real Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) in Pediatrics: A Clinical Case Report and Literature Review
    Joao Meira Goncalves, Sara Carvalho, Ana Isabel Silva, Josué Pereira, Patricia Polónia
    Cureus.2023;[Epub]     CrossRef
  • Pediatric Upper Cervical Spine Trauma: A 10-Year Retrospective Review at a Pediatric Trauma Center
    Sazid Hasan, Muhammad Waheed, Ameen K Suhrawardy, Collin Braithwaite, Lamia Ahmed, Philip Zakko, Jad G Khalil, Ehab S Saleh
    Cureus.2022;[Epub]     CrossRef
  • Pediatric Spine Trauma
    Sungjae An, Seung-Jae Hyun
    Journal of Korean Neurosurgical Society.2022; 65(3): 361.     CrossRef
  • Spinal cord injury in adult and pediatric populations
    Matthew J. Hagan, Joshua Feler, Felicia Sun, Owen P. Leary, Ankush Bajaj, Samika Kanekar, Adetokunbo A. Oyelese, Albert E. Telfeian, Ziya L. Gokaslan, Jared S. Fridley
    Interdisciplinary Neurosurgery.2022; 29: 101594.     CrossRef
  • Analysis of the Curative Effect and Prognostic Factors of Anterior Cervical Surgery for Spinal Cord Injury without Radiographic Abnormalities
    Jian Tan, Fanchen Hu, Jun Ou, Xiaotao Su, Jingnan Liu, Fenglin Liu
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
  • 19,221 View
  • 407 Download
  • 23 Web of Science
  • 30 Crossref

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
Close
Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.

Citations

Citations to this article as recorded by  Crossref logo
  • Spine Trauma Resource Priorities in Sub-Saharan Africa: A Delphi Approach
    Charlotte F. Wahle, Chellandra Samuels, Shravya Kakulamarri, Babapelumi Adejuyigbe, Trisha Tee, Francisco Gomez Alvarado, Saam Morshed, Ashraf N. El Naga, David W. Shearer, David Gendelberg
    Global Spine Journal.2026; 16(3): 1501.     CrossRef
  • A prediction model for postoperative respiratory failure in patients with traumatic cervical spinal cord injury using interpretable machine learning
    Miao Yu, Hui Xing, Tao Jiang, Chao Zhang, Xianjun Ren, Minghan Liu, Changqing Li
    European Spine Journal.2026; 35(2): 959.     CrossRef
  • Clinical Guidelines and Their Role in Trauma-related Cervical Spine Imaging
    Masis Isikbay, Jason Talbott
    Radiology.2026;[Epub]     CrossRef
  • Computer-vision based recognition of cervical spine stabilization during trauma resuscitation
    Mary S. Kim, Sifan Yuan, Genevieve J. Sippel, Aaron H. Mun, Dylan W. Arkowitz, Ivan Marsic, Randall S. Burd
    Injury.2026; 57(2): 112951.     CrossRef
  • Variations in Managing Acute Spinal Cord Injury in the North American Clinical Trials Network and Partner Institutes
    Teleale Fikru Gebeyehu, Zachary Sokol, James D. Guest, Joseph D. Harrington, Ashmal Sami Kabani, Evan Fitchett, Alejandro Lopez, Stavros Matsoukas, Daniel Franco, Jack Jallo, Alexander R. Vaccaro, Muhammad Abd-El-Barr, Shekar N. Kurpad, Charles H. Tator,
    Global Spine Journal.2026;[Epub]     CrossRef
  • The Utility of Routine Postoperative Radiographs Following Surgical Treatment of Traumatic Cervical Spine Injuries
    Hershil Patel, Sapan Patel, Rohan I. Suresh, Vishal A. Khatri, Keerthana Srinivasan, Husni Alasadi, Evan Honig, Ryan Curto, Usman Zareef, Robin Fencel, Alexander Padovano, Louis J. Bivona, Daniel L. Cavanaugh, Eugene Y. Koh, Steven C. Ludwig, Julio J. Jau
    Journal of Clinical Medicine.2026; 15(6): 2231.     CrossRef
  • Subaxial cervical spine fractures with facet joint dislocation: Surgical management, technique, and results in a retrospective series of 36 patients
    Angelo Rusconi, Stefano Peron, Delia Cannizzaro, Alberto Campione, Roberto Stefini
    Journal of Craniovertebral Junction and Spine.2026; 17(3): 279.     CrossRef
  • 3D-printed guide template for cervical stabilization surgery: A case report
    Koray Ur, Hatun Mine Şahin, Timurhan Aksoy, Ceren Kızmazoğlu, Reşat Serhat Erbayraktar
    Brain and Spine.2025; 5: 104267.     CrossRef
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    Madelon Thevis, Jolanda Derks, Thijs T.G. Jansen, Allard J.F. Hosman, Henricus P.M. Kunst
    Journal of Neurological Surgery Part B: Skull Base.2025; 86(06): e8.     CrossRef
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    Global Spine Journal.2025; 15(4): 2547.     CrossRef
  • Evaluación de los recursos de atención de trauma en hospitales de media y baja complejidad de Cali, Colombia: un estudio observacional multicéntrico
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    Nur Amelia S Shaharudin, Olivia A Dunseath, Nur Aina Azmi, Ning Yee Aun
    Cureus.2025;[Epub]     CrossRef
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    European Spine Journal.2025;[Epub]     CrossRef
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    Journal of Clinical Medicine.2024; 13(8): 2325.     CrossRef
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    The Spine Journal.2024; 24(9): 1571.     CrossRef
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    Spine.2024; 49(16): 1171.     CrossRef
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    Prehospital Emergency Care.2023; 27(2): 131.     CrossRef
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    IGLNA Artha Wiguna, I Ketut Suyasa, Hans K Nugraha
    JBJS Case Connector.2023;[Epub]     CrossRef
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    Biomechanics.2023; 3(1): 136.     CrossRef
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    Ke Liu, Zhengfeng Zhang
    Neurospine.2023; 20(1): 181.     CrossRef
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    Revista de la Asociación Argentina de Ortopedia y Traumatología.2023; 88(2): 138.     CrossRef
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    Caterina Zardo, Antonello Carta
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    Svetlana I. Tolstaya, Galina E. Ivanova, Oleg V. Durov, Igor A. Lavrov, Vladimir P. Baklaushev, Vladimir V. Belopasov
    Journal of Clinical Practice.2023; 14(2): 54.     CrossRef
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    Iftakher Hossain, Elham Rostami, Niklas Marklund
    Current Opinion in Critical Care.2023; 29(6): 650.     CrossRef
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    Open Journal of Modern Neurosurgery.2023; 13(03): 137.     CrossRef
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    Amit Shukla, Suyash Singh
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    Ron Gadot, David N. Smith, Marc Prablek, Joey K. Grochmal, Alfonso Fuentes, Alexander E. Ropper
    Neurospine.2022; 19(2): 283.     CrossRef
  • Exploring perspectives and adherence to guidelines for adult spinal trauma in low and middle-income healthcare economies: A survey on barriers and possible solutions (part I)
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    Brain and Spine.2022; 2: 100932.     CrossRef
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    International journal of health sciences.2022; 6(S10): 1816.     CrossRef
  • 24,095 View
  • 544 Download
  • 32 Web of Science
  • 40 Crossref