Clinical and magnetic resonance imaging correlation in acute spinal cord injury

Ramon, Sesquile; Domínguez, Rodrigo; Ramírez, Leonardo Gutiérrez; Paraira, Marta; Olona, Montserrat; Castelló, T; Fernandez, Luis

doi:10.1038/sj.sc.3100490

Cited by 134 publications

(72 citation statements)

References 17 publications

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“…5 In a recent study, Machino et al 3 correlated the MRI findings seen in SCIWORET with the severity of neurological deficit and surgical outcome. They divided the MRI findings into intramedullary high-signal intensity and PVH.…”

Section: Discussionmentioning

confidence: 99%

“…The type of cord injury was categorized as described by Ramon et al 5 Mid-saggital MR images were analysed for spinal cord changes and were classified as normal cord, type I pattern (cord haemorrhage), type II pattern (cord oedema), type III pattern (contusion or mixed), compression pattern and transection pattern. 5 The extent of cord damage and the extent of prevertebral hyperintensity (PVH) 3 was measured as the number of segments involved with respect to the cervical vertebrae. 6 Each vertebral body was divided into two parts: the upper half or segment 1 and the lower half or segment 2.…”

Section: Radiological Evaluationmentioning

confidence: 99%

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Cervical spinal cord injuries without radiographic evidence of trauma: a prospective study

et al. 2013

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Study design: Prospective study. Objectives: In a prospective study, 45 consecutive cases of cervical spinal cord injury without radiographic evidence of trauma (SCIWORET) who were treated non-operatively were analyzed to correlate the magnetic resonance image findings with the initial neurological deficit and the extent of neurological recovery at 2 years. Setting: University tertiary-care teaching hospital in South India. Methods: The neurological status of patients who did not have any radiographic or computerized tomographic abnormality at the time of admission was assessed by ASIA Impairment Scale (AIS) modification of Frankel's grading. The spinal cord abnormality seen in the magnetic resonance imaging was noted. The neurological status at the end of 2 years was recorded. Results: Twenty-seven of the 45 patients (60%) had cord oedema, 8 (17.77%) had cord contusion, 8 (17.77%) patients had a normal cord and 2 (4.44%) patients had cord swelling on the magnetic resonance image. Out of 27 patients who presented with cord oedema, 14 (31.11%) patients recovered from AIS D to AIS E and 6 (13.33%) patients did not recover and remained at AIS D. Seven (15.55%) patients who had a normal cord recovered completely to AIS E. Five (11.11%) patients who had contusion of the cord recovered up to AIS D. Conclusion: The initial neurological status correlates with magnetic resonance imaging findings. Subsequent neurological recovery is dependent on the type of cord damage and initial neurological status. The rate of recovery and the final motor outcome are inversely related to the length of cord involvement.

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Section: Discussionmentioning

confidence: 99%

Section: Radiological Evaluationmentioning

confidence: 99%

Cervical spinal cord injuries without radiographic evidence of trauma: a prospective study

et al. 2013

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“…9,[12][13][14] Edema is seen in T2 MR imaging sequences as hyperintensity of the signal within the cord, whereas a low intensity area on T2-weighted images in the acute stage is thought to indicate intramedullary hemorrhage, attributed to deoxyhemoglobin. 15,16 In addition, because hemorrhage is almost always concurrent with edema, it is common to measure signal hyperintensity in T2-weighted images to determine the length of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Injury after Blunt Cervical Spine Trauma: Correlation of Soft-Tissue Damage and Extension of Lesion

Martínez-Pérez¹,

Paredes²,

Cepeda³

et al. 2013

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length.

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“…Although clinically relevant correlations between acute-phase magnetic resonance imaging findings and neurological outcomes have been reported in SCI patients, no studies reporting significant correlation between magnetic resonance imaging findings and initial neurological examination results have been published to date. [17][18][19][20] Nonetheless, as diagnostic imaging technology continues to evolve, future modification of SCI syndrome definitions may occur.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic criteria of traumatic central cord syndrome. Part 2: A Questionnaire Survey among Spine Specialists

et al. 2010

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Study design: A questionnaire survey. Objectives: To evaluate the need for the introduction of quantitative diagnostic criteria for the traumatic central cord syndrome (TCCS). Setting: An online questionnaire survey with participants from all over the world. Methods: An invitation to participate in an eight-item online survey questionnaire was sent to surgeon members of AOSpine International. Results: Out of 3340 invited professionals, 157 surgeons (5%) from 41 countries completed the survey. Whereas most of the respondents (75%) described greater impairment of the upper extremities than of the lower extremities in their own TCCS definitions, symptoms such as sensory deficit (39%) and bladder dysfunctions (24%) were reported less frequently. Initially, any difference in motor strength between the upper and lower extremities was considered most frequently (23%) as a 'disproportionate' difference in power. However, after presenting literature review findings, the majority of surgeons (61%) considered a proposed difference of at least 10 points of power (based on the Medical Research Council scale) in favor of the lower extremities as an acceptable cutoff criterion for a diagnosis of TCCS. Most of the participants (40%) felt that applying a single criterion to the diagnosis of TCCS is insufficient for research purposes. Conclusion: Various definitions of TCCS were used by physicians involved in the spinal trauma care. The authors consider a difference of at least 10 motor score points between upper and lower extremity power a clear diagnostic criterion. For clinical research purposes, this diagnostic criterion can be considered as a face valid addendum to the commonly applied TCCS definition as introduced by Schneider et al.

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Clinical and magnetic resonance imaging correlation in acute spinal cord injury

Cited by 134 publications

References 17 publications

Cervical spinal cord injuries without radiographic evidence of trauma: a prospective study

Cervical spinal cord injuries without radiographic evidence of trauma: a prospective study

Spinal Cord Injury after Blunt Cervical Spine Trauma: Correlation of Soft-Tissue Damage and Extension of Lesion

Diagnostic criteria of traumatic central cord syndrome. Part 2: A Questionnaire Survey among Spine Specialists

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