"Our study demonstrates that the possibility and extent of neurological recovery after spinal cord injury can be predicted within 48 hours after injury by rigorous assessment of magnetic resonance images," said co-author Michael G. Fehlings, M.D., Ph.D., professor of neurosurgery at the University of Toronto. "In addition," Dr. Fehlings said, "these findings could result in a more aggressive clinical strategy for patients who may appear to have a severe spinal cord injury but may indeed have the capacity for substantial neurological recovery."
Dr. Fehlings’ study included 100 patients with traumatic cervical acute spinal cord injuries (SCI). The group consisted of 79 men and 21 women between the ages of 17 and 96. Complete motor and sensory SCI was seen in 26 patients, incomplete SCI was seen in 51 patients, and 22 patients were neurologically intact upon admission. One patient could not be classified. The majority of the patients had been injured in motor vehicle accidents.
Magnetic resonance imaging (MRI) exams were obtained within 24 to 48 hours of injury. The research team studied three measurable imaging parameters: maximum spinal cord compression (MSCC), maximum canal compromise (MCC) and length of lesion (LOL). They also looked at other factors, including bleeding within the spine, swelling and soft tissue injury.
The results showed that severity of MSCC, bleeding and cord swelling were key indicators of a poor prognosis after SCI. Conversely, the absence of these symptoms indicated a good chance for neurological recovery even if the injury otherwise appeared severe.
"Since the severity of spinal cord compression is a predictor of outcome after SCI, this study suggests that MRI may predict which patients would benefit the most from decompressive surgery," Dr. Fehlings said.
MEDICA.de; Source: Radiological Society of North America