Injury to the spinal cord without radiological abnormality (SCIWORA) in adults

Injury to the spinal cord without radiological abnormality often occurs in the skeletally immature cervical and thoracic spine. We describe four adult patients with this diagnosis involving the cervical spine with resultant q uadriparesis, The relevant literature is reviewed. The implications for ini tial management of the injury, the role of MRI and the need for a high inde x of suspicion are highlighted.