Projects

Purpose Utility of MRI for predicting neurological outcomes in acute cervical spinal cord injury (SCI) is well established
but its value in thoracolumbar (TL) SCI needs to be evaluated.
Methods Seventy-six patients operated for acute TL spinal injuries between January 2014 and March 2016 were reviewed
to obtain demographic details, neurology at admission and at the final follow-up. Patients were divided based on the neurology
at presentation into group 1 (ASIA A), group 2 (ASIA B, C, D) and group 3 (normal neurology). Preoperative MRI and
CT scans were evaluated to measure parameters like osseus canal compromise, spinal cord compression (SCC), spinal cord
swelling, length of cord swelling (LOS), length of edema (LOE) and the presence of hemorrhage. The MRI parameters were
compared between the groups for their predictive value of neurology on admission and at the final follow-up.
Results Of the 38 patients in group 1, six patients recovered by 1 grade, nine patients recovered by 2 grades and there was
no recovery in 23 (60.5%) patients. Among group 2 patients, nine (40.9%) out of 22 recovered to ASIA E neurology. On
univariate analysis, SCC (P = 0.009), LOS (P = 0.021) and length of edema (P = 0.002) were associated with complete
neurological deficit at presentation. However, on multivariate regression analysis only LOE was significant (P = 0.007) in
predicting neurology at admission and at follow-up.
Conclusion Greater the rostrocaudal LOE, worse is the neurology at presentation, and it is associated with poor neurological
recovery at follow-up.