Spinal cord injury without radiographic abnormalities in children and adolescents: case report of a severe cervical spine lesion and review of literature.

Abstract

The biomechanics of the child's and juvenile's spine is responsible for the commonly encountered closed spinal trauma with significant neurological injury but without bony or ligament injury (particularly of the cervical spine). The ligamentous laxity and hypermobility of the young bony cervical and thoracic spine predispose to spinal cord injury without radiographic abnormalities. We report a 16-year-old girl with typical features of this type of injury after a "flic-flac" sports injury. We conclude that children and adolescents who have neurological deficits without positive radiographic findings require appropriate diagnostic screening, monitoring, and often a prolonged therapy. The sometimes changing neurological deficits should never be ignored or dismissed as psychogenic affection.