Volume X Issue X (2023) 1 https://doi.org/10.36922/itps.1386 REVIEW ARTICLE Guidelines for treating spinal cord injury without radiological abnormalities in children Ruba Altahla 1 , Jamal Alshorman 2 , and Xu Tao 1 * 1 Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 2 Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Abstract Spinal cord injury without radiological abnormality (SCIWORA) is a rare condition that predominantly afects children. The enigmatic nature of SCIWORA poses signifcant challenges in terms of diagnosis, treatment, and achieving full recovery. Various factors, such as diferent injury mechanisms, delayed symptom onset, normal magnetic resonance imaging fndings in certain cases, and complex management decisions, contribute to the challenges of dealing with SCIWORA. Attaining a signifcant outcome and complete recovery through a single-treatment approach is difcult. Therefore, a multifaceted treatment strategy is proposed to yield more favorable results. This paper comprehensively addresses the assessment and management, examination and diagnosis procedures, treatment methods, rehabilitation techniques, and potential complications associated with SCIWORA in children. The paper provides therapeutic guidance for physicians and medical staf, with the aim of enhancing survival rates and improving recovery outcomes. Moreover, it ofers suggestions for restoring neurological functions in pediatric patients sufering from SCIWORA. Keywords: Spinal cord injury without radiological abnormality; Pediatrics; Magnetic resonance imaging; Surgery; Therapeutic treatment; Rehabilitation 1. Introduction Te original description of spinal cord injury without radiological abnormality (SCIWORA) was frst published in 1982 [1] . SCIWORA is a rare disease that primarily afects children but also occurs in adults, with a higher prevalence in children due to anatomical diferences and the mechanism of injury (MOI). In children outside of China, 75% of spinal cord injuries (SCIs) are attributed to violent trauma, such as sports-related injuries, child abuse, motor vehicle accidents, falls, and diving accidents. Conversely, in China, 50% of cases result from nonviolent trauma during dance training, particularly related to backbend movements [2] . Te underlying mechanism of SCIWORA in children is complicated and difers from that in adults [3] . Te biomechanics of the pediatric spine plays an important role in this condition. Compared to adults, the higher elasticity of the children’s spine increases the risk of developing SCIWORA. Factors such as fexion, hyperextension, longitudinal distraction, and ischemia can contribute to SCIWORA in *Corresponding author: Xu Tao (i202122089@hust.edu.cn) Citation: Altahla R, Alshorman J and Tao X, 2023, Guidelines for treating spinal cord injury without radiological abnormalities in children. INNOSC Theranostics and Pharmacological Sciences. https://doi.org/10.36922/itps.1386 Received: July 27, 2023 Accepted: September 6, 2023 Published Online: October 13, 2023 Copyright: © 2023 Author(s). This is an Open-Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution, and reproduction in any medium, provided the original work is properly cited. Publisher’s Note: AccScience Publishing remains neutral with regard to jurisdictional claims in published maps and institutional affliations. INNOSC Theranostics and Pharmacological Sciences