Evaluation of the prognostic value of extra-parenchymal changes in traumatic spinal cord injury, assessed by magnetic resonance imaging

Abstract

[Abstract] Objectives: To analyze the relationship between neurological progression following traumatic spinal cord injury and Spinal Cord Compression (SCC) and Spinal Ligamentous Injury (LI) by magnetic resonance imaging.

Design: Retrospective observational study.

Setting: Spinal Cord Injury Unit (A Coruña, Spain).

Participants: Patients were admitted for traumatic spinal cord injury between January 2010 and December 2018 with a magnetic resonance imaging examination performed during the acute phase.

Intervention: Evaluation of SCC and LI by magnetic resonance imaging.

Outcome measures: Comparisons between neurological examination at admission and discharge were made, assessing ASIA Impairment Scale (AIS) grade and motor score.

Results: Data from 296 patients were collected. A relationship between SCC and LI and complete injuries were found (P < 0.001). Improvement of the AIS grade was observed in 31.6% of patients with SCC and 31.3% with LI versus 42.7% and 37.8% of subjects without these complications, respectively. Regarding motor score, patients with SCC had lower mean values at the beginning (46.9 ± 26.8 versus 61.1 ± 29.9 in the control group, P < 0.001), as well as less improvement when assessed by the percentage of change (35.1 ± 37.5% versus 49.4 ± 38.1% in the control group, P = 0.010). Similar results were obtained in cases with LI: mean motor score at admission was 45.9 ± 26.7 versus 54.9 ± 29.4 in the control group (P = 0.014) and the percentage of change was 28.5 ± 37.1% in comparison to 46.0 ± 37.5% (P = 0.001) in the controls.

Conclusions: There is a relationship between SCC and LI and complete spinal cord injury. This patient population has lower possibilities of improving their AIS grade and motor score.