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. 2011 Dec;1(1):1-8.
doi: 10.1055/s-0031-1296049.

Diagnosis and prognosis of traumatic spinal cord injury

Joost J van Middendorp  1 , Ben Goss  2 , Susan Urquhart  3 , Sridhar Atresh  3 , Richard P Williams  4 , Michael Schuetz  1
Affiliations

Diagnosis and prognosis of traumatic spinal cord injury

Joost J van Middendorp et al. Global Spine J. 2011 Dec.

Abstract

Despite promising advances in basic spinal cord repair research, no effective therapy resulting in major neurological or functional recovery after traumatic spinal cord injury (tSCI) is available to date. The neurological examination according to the International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients (International Standards) has become the cornerstone in the assessment of the severity and level of the injury. Based on parameters from the International Standards, physicians are able to inform patients about the predicted long-term outcomes, including the ability to walk, with high accuracy. In those patients who cannot participate in a reliable physical neurological examination, magnetic resonance imaging and electrophysiological examinations may provide useful diagnostic and prognostic information. As clinical research on this topic continues, the prognostic value of the reviewed diagnostic assessments will become more accurate in the near future. These advances will provide useful information for physicians to counsel tSCI patients and their families during the catastrophic initial phase after the injury.

Keywords: diagnosis; prognosis; review; spinal cord injury.

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Figures

Figure 1
Figure 1
The scoring form of the International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients, available on the following Web site: http://www.asia-spinalinjury.org/publications/59544_Sc_Exam_Sheet_r4.pdf
Figure 2
Figure 2
Sagittal T2-weighted magnetic resonance image of the cervical spinal cord in a patient with a traumatic spinal cord injury. The three classical features of a severe spinal cord injury, including spinal cord hemorrhage (C4–C6), spinal cord edema (C1–T3, very distinct), and spinal cord swelling (C1–T3, not very distinct) are present.
Figure 3
Figure 3
Graphic representation of the predicted probability of independent ambulation 1 year postinjury based on the prediction rule score. The prediction rule score (x-axis, see Table 4 ) is plotted out against the probability of walking independently 1 year postinjury (y-axis). The light gray area around the curve represents the 95% confidence interval of the prediction rule based on the regression model. The dashed lines are a visual aid to determine the probability of walking independently.
See this image and copyright information in PMC

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