The study by Mohanty et al.1 correlates magnetic resonance imaging (MRI) findings and initial neurological status with the mid-term outcome of patients presenting with discordant clinical and radiological findings after cervical spinal cord trauma. They enrolled 45 patients and employed a standardized diagnostic and conservative treatment protocol. Their detailed description of the largest non-operatively managed cohort of patients with spinal cord injuries without radiographic evidence of trauma (SCIWORET) is an important contribution to the field.

Observed in 16.5% of all cervical spine injuries, the relatively high incidence rate of SCIWORET is especially noteworthy. Their findings suggest a correlation between initial neurologic status and mid-term functional outcome, and describe a statistically significant correlation between intraspinal MRI findings and initial as well as mid-term neurologic status. Finally, Mohanty et al.1 highlight the importance of the length of prevertebral hyperintensity (PVH) as a risk factor for poor neurological outcome, thus paralleling the results of a previously published operatively managed cohort.

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