A PEDIATRIC CASE OF SPINAL CORD INJURY WITHOUT RADIOLOGICAL ABNORMALITY

Abstract

　　We recently encountered a child with cervical cord injury without bone lesion. The patient was an 11-year-old boy. During physical exercise, his neck transiently became intensely extended. Despite the absence of an evident injury on external examination, the child began to complain of neck pain and muscular weakness developed in both arms and the right leg. He was therefore brought to a local clinic. At that time, MRI of the cervical spinal cord did not detect any abnormalities. The patient was referred to our hospital to receive a more detailed examination. On admission day 2, muscular weakness of the left leg and an increase in leg tendon reflex developed. Cervical cord MRI was carried out again, demonstrating cervical cord lesions at the C3-C7 levels without being accompanied by any evident bone lesion. Patients with cervical cord injury sometimes do not present any significant abnormalities on diagnostic images taken immediately after injury despite the presence of signs of neurological abnormalities. As in the case of elderly patients, careful follow-up is necessary when dealing with injured children if the possibility of cervical cord lesions cannot be ruled out after considering the mechanism of injury.