Neurologic recovery according to early magnetic resonance imaging findings in traumatic cervical spinal cord injuries

Abstract

The aim of this study was to determine the usefulness of early magnetic resonance imaging findings in predicting neurologic recovery at or below the injured level in traumatic cervical spinal cord injuries. Thirty patients with traumatic cervical spinal cord injuries were included. All of the patients received a magnetic resonance imaging and a neurologic examination in the emergency room, within 7 days of injury and at 6 months following the injury. To quantify neurologic recovery below the injured level, we modified clinical scales, particularly the motor ratio and the sensory ratio. We used the neurologic level to quantify recovery around the injured level. We assessed neurologic recovery according to MRI patterns and lesion extents. The pure hemorrhagic MRI pattern was not observed. In edematous and mixed types, the improvement of neurologic levels was not significantly different. The motor ratio and sensory ratio improved significantly more in edematous type patients than in mixed type patients. Based on MRI lesion extent, the improvement of neurologic levels was not significantly different, and motor ratio and sensory ratio improved significantly more in those with one or two segments involved than in those with more than two segments involved. In conclusion, early MRI pattern and lesion extent after traumatic cervical spinal cord injury may provide important information to help predict neurologic recovery, especially below the injured level.

Fig. 1

Comparison of recovery rate of motor ratio and sensory ratio between edematous type and mixed type. The recovery rate of motor ratio and sensory ratio was significantly higher in the edematous type than in the mixed type (p < 0.05).

Fig. 2

Comparison of recovery rate of motor ratio and sensory ratio between groups. We classified as group I, when the alteration of intensity lies at one or two segments, and more than two segments as group II according to extent of lesion. The recovery rate of motor and sensory ratio was significantly higher in group I than in group II (p < 0.05).