Classification and surgical decision making in cervical spinal cord injury without radiologic evidence of trauma [Servikal spinal kord yaralanmasi{dotless}nda travmani{dotless}n radyolojik kani{dotless}ti{dotless} olmaksi{dotless}zi{dotless}n si{dotless}ni{dotless}flandi{dotless}rma ve cerrahi karar verme]

Objective: to evaluate retrospectively the preexisting factors,classification and corresponding surgical treatments for spinal cord injury without radiologic evidence of trauma (sciworet). methods: seventy-five patients with sciworet were reviewed to analyze their demographic information,mechanisms of injury,neurologic status,imaging manifestation,and surgical management along with outcome. classification for sciworet was proposed and unique aspects of this classification system along with surgical management and outcome was discussed. in this study,the american spinal cord injury association (asia) scale was used to evaluate the neurologic status of the patients and neurologic evaluation was performed before and after surgery according to the criteria proposed by the japanese orthopedic association (joa). results: the review indicated that there were chiefly 3 groups of preexisting factors as follows: (1) type i(20%): disc herniation or segmental instability. (2) type ii(52%):obvious decrease or even disappearance of the storing space of spinal canal,including congenital spinal canal stenosis,multi-segmental cervical spondylosis,ossification of the posterior longitudinal ligament (opll) (3) type iii(28%): decrease of the storing space of spinal canal combined with segmental instability or disc herniation.the postoperative follow-ups for the surgical treatment showed that neurologic status had been improved significantly in more than 80% of the patients with sciworet and the mean recovery rate with the joa score was 57.9% in type i,51.5% in type ii and 48.2% in type iii. conclusions: classification for sciworet according to preexisting factors may be used as a basic guidance for surgical decision-making and good outcomes can be achieved.