Tandem spinal cord injuries without radiographic abnormalities in a young child

Anatomic features unique to the pediatric spine render this population susc eptible to spinal cord injuries without radiographic abnormalities (SCIWORA ), To date, published descriptions of SCIWORA have been limited to a single region of the spinal column. We describe a case of a 3-year-old boy in who m, after a motor vehicle accident, tandem SCIWORA lesions involving the low er cervical spinal cord and thoracolumbar junction resulted in severe quadr aparesis, The child was initially treated with 24 h of methylprednisolone f ollowed by 3 months of external orthoses of both the cervical and thoracic spine. We include in this article a brief review of the literature and trea tment guidelines for SCIWORA and postulate the mechanism of these tandem sp inal cord injuries.