X-rays and CT show no signs of cervical fracture or dislocation, so why do patients develop spinal cord injuries? Today, we would like to introduce you to a special type of spinal cord injury – cervical spinal cord injury without fracture and dislocation. A 30-year-old woman was injured in a car accident and suffered a spinal cord injury with sensory and motor dysfunction of the extremities. Spinal cord injury without fracture-dislocation (SCIWOFD) is an indirect violent injury to the spinal cord in which there is no visible spinal fracture, dislocation or other abnormalities on X-rays and CT radiological examinations. 1, mostly due to external factors SCIWOFD is not rare in clinical practice, but it was not until 1982 that Pang classified it as a special type of spinal cord injury. Its incidence has a growing trend. Most of them are caused by external factors, such as falls on flat surfaces, bicycle falls, falls in bed, car crashes, etc. The non-fracture dislocation type of cervical spinal cord injury in adults is mostly seen in people with original cervical spine pathology, such as cervical degeneration, congenital, developmental or degenerative cervical spinal stenosis, cervical OPLL, congenital cervical deformity, etc., which can lead to cervical spinal cord injury and corresponding clinical symptoms after external force. 2, clinical manifestations of adult non-fracture dislocation type cervical spinal cord injury often traumatic violence degree is light, the degree of spinal cord injury is mostly incomplete injury. Most acute cervical spinal cord injuries without fracture and dislocation are incomplete moderate or mild spinal cord injuries. A brief period of spinal shock may occur in the early post-injury period, after which varying degrees of recovery of limb motor and sensory function may occur. Most patients with this type of injury will recover to varying degrees after early treatment with bed rest, dehydration and adrenocorticosteroids. However, the recovery often stops when it reaches a certain level, and most patients have recurrent mild to severe disease within months to years, resulting in increasing spinal cord dysfunction. 3, diagnosis based on trauma history, symptoms and signs of acute cervical spinal cord injury, X-ray examination does not find cervical fracture or dislocation, MRI examination found spinal cord compression or signal abnormalities, is the diagnosis of acute cervical spinal cord injury without fracture and dislocation type. In a few cases, there is a history of trauma with clinical manifestations of spinal cord injury, but MRI of the cervical spine does not show spinal cord compression. In order to clarify the diagnosis, in the case allowed by the orthopedic surgeon to protect the cervical hyperflexion, hyperextension X-ray examination, or dynamic MRI examination in extension and flexion, in order to find the possibility of extrusion of the spinal cord in the process of cervical activity. 4, should be early surgical treatment The vast majority of non-fracture dislocation type acute cervical spinal cord injury once the diagnosis is clear, should be early surgical treatment. Cervical MRI shows spinal cord compression, or there is obvious cervical segmental instability and associated with the plane of spinal cord injury, should be early surgical treatment. Very few patients may have clinical manifestations of spinal cord injury, but there is no spinal cord compression and no abnormal intervertebral joint activity associated with spinal cord injury, then there is no indication for surgery, but should be treated conservatively.