TY - JOUR
T1 - Non-locality and the misdiagnosis of Spinal Cord Injury Without Radiographic Abnormality
T2 - proof of concept
AU - Rolfe, Kevin
AU - Beck, Aaron
AU - Kovach, Tracy
AU - Mayeda, Brian
AU - Liu, Charles
N1 - Publisher Copyright:
© 2019, International Spinal Cord Society.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - 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.
AB - 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.
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U2 - 10.1038/s41394-019-0148-1
DO - 10.1038/s41394-019-0148-1
M3 - Article
C2 - 30729035
AN - SCOPUS:85074959608
SN - 2058-6124
VL - 5
JO - Spinal Cord Series and Cases
JF - Spinal Cord Series and Cases
IS - 1
M1 - 11
ER -