Spinal cord injury without radiographic abnormalities

Spinal cord injury without radiographic abnormality (SCIWORA) has a reported rate of incidence varying from 19% to 34% of all spinal cord injuries in children. This acronym refers to the presence of neurological lesion, despite normal plain radiographs, but where magnetic resonance imaging (MRI) shows significant pathology. The clinical evidence of the damage could be delayed in 6–54% of cases, usually within 48 h after the trauma. We report two patients affected by SCIWORA in the pediatric population. The first patient was a child of 22 months who had fallen when attempting to get out of bed. The second patient was an 11-month-old child admitted to the Emergency Service department after a car accident. Spinal cord injury has to be suspected in the presence of neurological signs, despite normal plain radiography. MRI is the appropriate diagnostic examination to identify the presence of SCIWORA.