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SCIWORA: A Pediatric Case

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 9-10. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/8/482676/LBORC-NUFA-Poster-Abstracts-2022-Residents)

Keywords:

case report [514]
OMT [2951]
osteopathic manipulative treatment [2973]
SCIWORA [1]
children [228]
pediatrics [375]
spinal cord injury without radiographic abnormality [1]

Abstract:

Introduction/background: Children possess a plasticity that makes spinal cord injuries rare. The anomaly Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) proves particularly difficult to treat because of the lack of radiological evidence for targeted therapies. It is estimated that 6-19% of spinal cord injuries in pediatric populations are true SCIWORA cases. SCIWORA remains underdiagnosed and undertreated. Case: 15-year-old Patient K survived a water sporting accident that left her with both somatic and autonomic deficits without corroborating radiographic evidence. Symptoms included: lost eyesight, headache, lost bladder control, decreased sensation and motor control of the right side of her body, severe mood lability, photophobia, and inability to concentrate. Patient K’s recovery became focused on functional rehabilitation including Osteopathic Manipulative Treatment (OMT) in which indirect unwinding of myofascial restrictions with sutural cranial manipulation was used. Results: After six 1-hour appointments over the course of 2.5 months, Patient K became pain-free with full strength in all extremities, decreased frequency of mood swings, decreased frequency and severity of headaches, and increased ability to walk long distances and run short distances with only mild abnormalities in gait. She no longer had autonomic instability or bladder incontinence. Discussion: Patient K progressed from not being able to do daily activities to going back to school after her OMT treatments. Her SCIWORA symptoms were thought to be due to diffuse microscopic shearing of cerebral and spinal vessels. OMT is documented as an effective treatment for neuropathic pain associated with spinal cord injury, but little research has been done in regard to structural and functional healing with manipulative therapies. More cases using OMT as treatment for SCIWORA are needed.


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