Real spinal cord injury without radiologic abnormality in pediatric patient with tight filum terminale following minor trauma: A case report

Abstract

Background: Spinal cord injury without radiographic abnormality (SCIWORA) is defined as having "clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability". The mechanism of pediatric SCIWORA following minor trauma is still unclear. Tight filum terminale (TFT) has been studied in the literature, but the information regarding the predisposing factor for SCIWORA is still being defined. Case presentation: We report three cases of thoracic and lumber SCIWORA with TFT. The trauma was potentially mild in all cases but resulted in catastrophic damage of the cord. All patients had no signs or symptoms of tethered cord syndrome prior to the minor trauma. TFT was found during operation. Conclusions: We suggest that TFT might be a predisposing factor for SCIWORA and chronic spinal cord traction play an important role in the mechanism of pediatric thoracic and lumber SCIWORA following minor trauma. Patients who never undergo treatment for TFT likely have an elevated risk of developing SCIWORA following minor trauma.