Physical therapy treatment of a pediatric patient with symptoms consistent with a spinal cord injury without radiographic abnormality: A retrospective case report.

This case report describes an 11-year-old wrestler who suffered a severe neck injury during competition that left him wheelchair-bound with pain, numbness, and weakness in his legs. Despite multiple medical tests showing no visible damage to his spine—a rare condition called SCIWORA (spinal cord injury without radiographic abnormality)—the young patient couldn't walk and required maximum assistance for basic movements. Nine days after the injury, he began physical therapy treatment that included electrical stimulation with heat, soft tissue massage, exercise, walking practice, and spinal manipulation targeting his neck, mid-back, and lower back regions. The spinal manipulation involved manual adjustments to restore proper alignment and movement to the vertebrae. After just 13 treatment sessions over five weeks, the boy made a complete recovery, walking independently and resuming all normal daily activities without pain or limitations. This case is particularly significant because spinal manipulation is sometimes considered risky for children, especially those with potential spinal cord involvement. However, when used carefully as part of a comprehensive treatment approach, it appeared safe and effective for this patient. While this report describes only one patient's experience and more research is needed, it suggests that manual therapies including spinal manipulation may benefit some pediatric patients with similar conditions. If considering bodywork or manual therapy for a child with a spinal injury, always seek treatment from a qualified, licensed practitioner experienced in pediatric care.

This retrospective case report documents treatment of an 11-year-old male wrestler presenting with SCIWORA following cervical trauma during competition. Clinical presentation included wheelchair dependence, bilateral lower extremity weakness and sensory deficits, and increased paraspinal muscle tone across cervical, thoracic, and lumbar regions despite negative diagnostic imaging. Physical therapy intervention began 9 days post-injury and consisted of interferential current with moist heat, myofascial release of paraspinal musculature, functional exercise, gait training, and spinal manipulative therapy (SMT) directed to cervical, thoracic, and lumbar segments. Following 13 treatments over 5 weeks, the patient achieved complete functional recovery with independent ambulation and resolution of pain and neurological symptoms. This case suggests SMT may be safely incorporated into multimodal treatment protocols for pediatric SCIWORA presentations. Given the single-patient design and lack of controlled comparison, practitioners should exercise clinical judgment and obtain appropriate imaging before implementing SMT in similar cases. Further investigation through larger studies is warranted to establish safety profiles and efficacy parameters.