Spinal card injury without radiographic abnormalities in children and adolescents: case report of a severe cervical spine lesion and review of literature

The biomechanics of the child's and juvenile's spine is responsible for the commonly encountered closed spinal trauma with significant neurological in jury but without bony or ligament injury (particularly of the cervical spin e). The ligamentous laxity and hypermobility of the young bony cervical and thoracic spine predispose to spinal cord injury without radiographic abnor malities. We report a 16-year-old girl with typical features of this type o f injury after a "flic-flac" sports injury. We conclude that children and a dolescents who have neurological deficits without positive radiographic fin dings require appropriate diagnostic screening, monitoring, and often a pro longed therapy. The sometimes changing neurological deficits should never b e ignored or dismissed as psychogenic affection.