{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:57:07Z","timestamp":1786755427508,"version":"build-2736575974"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The concept of spinal cord injury without radiographic abnormality (SCIWORA) was introduced in the 1980s. Unfortunately, the nomenclature creates confusion in the modern MRI-based era when applied to pediatric traumatic spinal injuries. The authors investigated the incidence and clinical characteristics of pediatric patients with true imaging-negative traumatic cervical spinal cord injuries (SCIs).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A prospective pediatric level I trauma center database at Primary Children\u2019s Hospital was queried to identify patients with cervical spine injuries tagged with \"SCIWORA\" or \"transient spinal cord injury.\" Demographic and clinical data were analyzed retrospectively after applying the following inclusion criteria: patient age < 18 years, evidence of transient neuropraxia on neurological examination, cervical spine MRI available for review, Glasgow Coma Scale (GCS) score \u2265 8, no intracranial pressure monitoring during hospitalization, and no evidence of SCI on MRI.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 22,909 patients were entered into the trauma database from 2005 to 2022. Of the 226 patients who met the initial search criteria, 21 met the final inclusion criteria. Eighteen patients (85.7%) were male, and the mean age was 13.66 \u00b1 2.48 years. The median GCS score was 15 (IQR 13\u201315). Neurological deficits noted on presentation included sensory, motor, and rectal tone loss in 19 (90.5%), 19 (90.5%), and 1 (4.8%) patient, respectively. The most common mechanism of injury was American football (10 patients, 47.6%), followed by wrestling (4, 19.0%) and motor vehicle collisions (2, 9.5%). The mean hospital stay was 1.81 \u00b1 0.98 days (range 1\u20135 days), with 3 (14.3%) patients admitted to the pediatric ICU for 1.33 \u00b1 0.58 days on average. All 21 patients were initially managed with a rigid cervical orthosis worn for 1\u201342 days (mean 4.57 \u00b1 5.42 days). Neurological symptoms completely resolved by discharge in 16 (76.2%) patients. The time necessary for neurological recovery was 1\u201315 days (mean 2.24 \u00b1 3.34 days). No patient required surgery or prolonged collar usage.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In this cohort, patients with MRI-negative neuropraxic cervical SCI were predominantly adolescent male athletes who recovered from their injuries within a few days without surgery or prolonged use of cervical collars. The authors assert that the term \"transient spinal neuropraxia in pediatric patients\" (T-SNIPP) is more appropriate to describe these injuries in the modern, MRI-based era of pediatric trauma care.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.3.peds24537","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T02:09:05Z","timestamp":1757124545000},"page":"547-552","source":"Crossref","is-referenced-by-count":1,"title":["Transient spinal neuropraxia in pediatric patients: analysis of an institutional experience 4 decades after the introduction of spinal cord injury without radiographic abnormality"],"prefix":"10.3171","volume":"36","author":[{"given":"Douglas L.","family":"Brockmeyer","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diwas","family":"Gautam","sequence":"additional","affiliation":[{"name":"Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City;"},{"name":"Department of Neurosurgery, Naval Medical Center San Diego, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyril","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie W.","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv R.","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Neurosurg","first-page":"114","article-title":"Spinal cord injury without radiographic abnormalities in children","volume":"57","author":"Pang D","year":"1982","unstructured":"Pang D, Wilberger JE Jr. Spinal cord injury without radiographic abnormalities in children. J Neurosurg. 1982;57(1):114\u2013129."},{"issue":"6","key":"b2","series-title":"Neurosurgery","first-page":"1325","article-title":"Spinal cord injury without radiographic abnormality in children, 2 decades later","volume":"55","author":"Pang D","year":"2004","unstructured":"Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325\u20131343."},{"issue":"1","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"30","article-title":"Utility of STIR MRI in pediatric cervical spine clearance after trauma","volume":"12","author":"Henry M","year":"2013","unstructured":"Henry M, Scarlata K, Riesenburger RI, Utility of STIR MRI in pediatric cervical spine clearance after trauma. J Neurosurg Pediatr. 2013;12(1):30\u201336."},{"issue":"5","key":"b4","series-title":"Surg Neurol","first-page":"347","article-title":"Spinal cord concussion","volume":"16","author":"Parkinson D","year":"1981","unstructured":"Parkinson D, Del Bigio M, Jell RM. Spinal cord concussion. Surg Neurol. 1981;16(5):347\u2013349."},{"issue":"2","key":"b5","series-title":"Acta Neurol Belg","first-page":"91","article-title":"Neuropraxia of the cervical spinal cord following cervical spinal cord trauma: a report of five patients","volume":"100","author":"Bernsen HJ","year":"2000","unstructured":"Bernsen HJ, Koetsveld A, Frenken CW, van Norel GJ. Neuropraxia of the cervical spinal cord following cervical spinal cord trauma: a report of five patients. Acta Neurol Belg. 2000;100(2):91\u201395."},{"issue":"3","key":"b6","series-title":"Clin Sports Med","first-page":"463","article-title":"Transient quadriparesis and cervical neuropraxia in elite athletes","volume":"40","author":"Hsu WK","year":"2021","unstructured":"Hsu WK. Transient quadriparesis and cervical neuropraxia in elite athletes. Clin Sports Med. 2021;40(3):463\u2013470."},{"issue":"6","key":"b7","series-title":"J Neurosurg","first-page":"894","article-title":"Spinal cord concussion","volume":"72","author":"Zwimpfer TJ","year":"1990","unstructured":"Zwimpfer TJ, Bernstein M. Spinal cord concussion. J Neurosurg. 1990;72(6):894\u2013900."},{"issue":"2","key":"b8","series-title":"Neurosurgery","first-page":"339","article-title":"Retrospective case series of spinal cord neurapraxia in male adolescent athletes: can these athletes return-to-play?","volume":"95","author":"Jo J","year":"2024","unstructured":"Jo J, Anesi TJ, Vance EH, Sills AK, Zuckerman SL, Bonfield CM. Retrospective case series of spinal cord neurapraxia in male adolescent athletes: can these athletes return-to-play?. Neurosurgery. 2024;95(2):339\u2013346."},{"issue":"5","key":"b9","series-title":"Childs Nerv Syst","first-page":"699","article-title":"The pediatric cervical spine instability study. A pilot study assessing the prognostic value of four imaging modalities in clearing the cervical spine for children with severe traumatic injuries","volume":"28","author":"Brockmeyer DL","year":"2012","unstructured":"Brockmeyer DL, Ragel BT, Kestle JRW. The pediatric cervical spine instability study. A pilot study assessing the prognostic value of four imaging modalities in clearing the cervical spine for children with severe traumatic injuries. Childs Nerv Syst. 2012;28(5):699\u2013705."},{"issue":"24","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"2788","article-title":"Pediatric spinal cord injury without radiographic abnormality (SCIWORA): the absence of occult instability and lack of indication for bracing","volume":"27","author":"Bosch PP","year":"2002","unstructured":"Bosch PP, Vogt MT, Ward WT. Pediatric spinal cord injury without radiographic abnormality (SCIWORA): the absence of occult instability and lack of indication for bracing. Spine (Phila Pa 1976). 2002;27(24):2788\u20132800."},{"issue":"6","key":"b11","series-title":"Global Spine J","first-page":"1208","article-title":"Management and mid-term outcome after \"real SCIWORA\" in children and adolescents","volume":"12","author":"Freigang V","year":"2022","unstructured":"Freigang V, Butz K, Seebauer CT, Management and mid-term outcome after \"real SCIWORA\" in children and adolescents. Global Spine J. 2022;12(6):1208\u20131213."},{"issue":"1","key":"b1","series-title":"J Neurosurg","first-page":"114","article-title":"Spinal cord injury without radiographic abnormalities in children","volume":"57","author":"Pang D","year":"1982","unstructured":"Pang D, Wilberger JE Jr. Spinal cord injury without radiographic abnormalities in children. J Neurosurg. 1982;57(1):114\u2013129."},{"issue":"6","key":"b2","series-title":"Neurosurgery","first-page":"1325","article-title":"Spinal cord injury without radiographic abnormality in children, 2 decades later","volume":"55","author":"Pang D","year":"2004","unstructured":"Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery. 2004;55(6):1325\u20131343."},{"issue":"1","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"30","article-title":"Utility of STIR MRI in pediatric cervical spine clearance after trauma","volume":"12","author":"Henry M","year":"2013","unstructured":"Henry M, Scarlata K, Riesenburger RI, Utility of STIR MRI in pediatric cervical spine clearance after trauma. J Neurosurg Pediatr. 2013;12(1):30\u201336."},{"issue":"5","key":"b4","series-title":"Surg Neurol","first-page":"347","article-title":"Spinal cord concussion","volume":"16","author":"Parkinson D","year":"1981","unstructured":"Parkinson D, Del Bigio M, Jell RM. Spinal cord concussion. Surg Neurol. 1981;16(5):347\u2013349."},{"issue":"2","key":"b5","series-title":"Acta Neurol Belg","first-page":"91","article-title":"Neuropraxia of the cervical spinal cord following cervical spinal cord trauma: a report of five patients","volume":"100","author":"Bernsen HJ","year":"2000","unstructured":"Bernsen HJ, Koetsveld A, Frenken CW, van Norel GJ. Neuropraxia of the cervical spinal cord following cervical spinal cord trauma: a report of five patients. Acta Neurol Belg. 2000;100(2):91\u201395."},{"issue":"3","key":"b6","series-title":"Clin Sports Med","first-page":"463","article-title":"Transient quadriparesis and cervical neuropraxia in elite athletes","volume":"40","author":"Hsu WK","year":"2021","unstructured":"Hsu WK. Transient quadriparesis and cervical neuropraxia in elite athletes. Clin Sports Med. 2021;40(3):463\u2013470."},{"issue":"6","key":"b7","series-title":"J Neurosurg","first-page":"894","article-title":"Spinal cord concussion","volume":"72","author":"Zwimpfer TJ","year":"1990","unstructured":"Zwimpfer TJ, Bernstein M. Spinal cord concussion. J Neurosurg. 1990;72(6):894\u2013900."},{"issue":"2","key":"b8","series-title":"Neurosurgery","first-page":"339","article-title":"Retrospective case series of spinal cord neurapraxia in male adolescent athletes: can these athletes return-to-play?","volume":"95","author":"Jo J","year":"2024","unstructured":"Jo J, Anesi TJ, Vance EH, Sills AK, Zuckerman SL, Bonfield CM. Retrospective case series of spinal cord neurapraxia in male adolescent athletes: can these athletes return-to-play?. Neurosurgery. 2024;95(2):339\u2013346."},{"issue":"5","key":"b9","series-title":"Childs Nerv Syst","first-page":"699","article-title":"The pediatric cervical spine instability study. A pilot study assessing the prognostic value of four imaging modalities in clearing the cervical spine for children with severe traumatic injuries","volume":"28","author":"Brockmeyer DL","year":"2012","unstructured":"Brockmeyer DL, Ragel BT, Kestle JRW. The pediatric cervical spine instability study. A pilot study assessing the prognostic value of four imaging modalities in clearing the cervical spine for children with severe traumatic injuries. Childs Nerv Syst. 2012;28(5):699\u2013705."},{"issue":"24","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"2788","article-title":"Pediatric spinal cord injury without radiographic abnormality (SCIWORA): the absence of occult instability and lack of indication for bracing","volume":"27","author":"Bosch PP","year":"2002","unstructured":"Bosch PP, Vogt MT, Ward WT. Pediatric spinal cord injury without radiographic abnormality (SCIWORA): the absence of occult instability and lack of indication for bracing. Spine (Phila Pa 1976). 2002;27(24):2788\u20132800."},{"issue":"6","key":"b11","series-title":"Global Spine J","first-page":"1208","article-title":"Management and mid-term outcome after \"real SCIWORA\" in children and adolescents","volume":"12","author":"Freigang V","year":"2022","unstructured":"Freigang V, Butz K, Seebauer CT, Management and mid-term outcome after \"real SCIWORA\" in children and adolescents. 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