Non-locality and the misdiagnosis of Spinal Cord Injury Without Radiographic Abnormality: proof of concept

Kevin Rolfe, Aaron Beck, Tracy Kovach, Brian Mayeda, Charles Liu

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Study Design: This is a retrospective review. Objectives: To validate the concept of “non-locality” to explain cases of Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) previously deemed inexplicable. To investigate and challenge the source data for the SCIWORA hypothesis which has the built-in assumption that a traumatic spinal cord injury (SCI) can only be caused by a local or adjacent spinal column injury and which, therefore, postulates that the pediatric spinal column is inherently more flexible than the spinal cord to explain SCI whenever a local spinal column injury is not detected. Setting: A National Rehabilitation Center, one of fourteen which reports to the Spinal Cord Injury Model System. Methods: We examined all residual SCIWORA cases over a 5-year period. In addition, we performed an extensive literature search to trace the evidence supporting the SCIWORA hypothesis that children’s spinal columns are inherently lax and may stretch more than the spinal cord prior to disruption. Results: Six SCI patients with a residual diagnosis of SCIWORA were identified, 3 pediatric and 3 adult. All had injuries fitting non-locality. None were an actual SCIWORA. Source data do not appear to support the SCIWORA hypothesis. Conclusion: Borrowing from quantum mechanics, we reveal non-locality as a real entity in the spine. The assumption of locality-only is invalid and likely contributed to the SCIWORA hypothesis for the pediatric spine. Misdiagnosis and misunderstanding of SCIWORA may lead to improper treatment and increased cost. Awareness may facilitate search for adequate explanations for difficult cases rather than mere assignment as SCIWORA.

Original languageEnglish (US)
Article number11
JournalSpinal Cord Series and Cases
Volume5
Issue number1
DOIs
StatePublished - Dec 1 2019

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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