Emergency Magnetic Resonance Imaging of Cervical Spinal Cord Injuries: Clinical Correlation and Prognosis

Selden, Nathan R.; Quint, Douglas J.; Patel, Nandish V.; d’Arcy, Hannah; Papadopoulos, Stephen M.

doi:10.1097/00006123-199904000-00057

Cited by 124 publications

(119 citation statements)

References 19 publications

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“…9,10,12,19 In recent years, the radiological assessment protocol for acute cervical spine trauma was challenged: increasingly the three standard radiological views are combined with MRI or helical CT of the complete cervical spine instead of conventional CT. [5][6][7] Especially in patients with neurological dysfunction, MRI probably is the first radiological modality to be applied. 4,5 Multiplane MRI not only depicts eventual neurocompression and discoligamentous injury, it may also show haematomyelia, cord transection and cord oedema. 4,10 Cord lesions with T1-weighted iso-to hypointense and T2-weighted hyperintense MRI images are suggestive of cord contusion and oedema.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Multiplane MRI not only depicts eventual neurocompression and discoligamentous injury, it may also show haematomyelia, cord transection and cord oedema. 4,10 Cord lesions with T1-weighted iso-to hypointense and T2-weighted hyperintense MRI images are suggestive of cord contusion and oedema. 5,7,10,13,14 At the present time, MRI resolution for differentiation of oedema with or without petechial haemorrhage is probably not yet reliable enough.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] However, in recent years this evaluation protocol was challenged by the introduction of magnetic resonance imaging (MRI) and helical CT of the complete cervical spine. 4 The latter diagnostic methods are increasingly used in the acute stage and especially in case of neurological dysfunction at first presentation or in case of negative results of initial plain films and conventional CT. [5][6][7] Moreover, plain films and CT, on which spinal cord injury without radiological abnormality (SCIWORA) diagnosis usually is based, may be insufficient and additionally miss soft-tissue lesions. 3,8,9 MRI depicts several types of intrinsic cord lesions as well as neurocompressive and discoligamentous injuries.…”

Section: Introductionmentioning

confidence: 99%

“…3,8,9 MRI depicts several types of intrinsic cord lesions as well as neurocompressive and discoligamentous injuries. 4,10,11 The latter may be indicative of an unstable cervical spine with the danger of ongoing cord damage. 12 Such conditions can be validated in the reliable patient by means of dynamic flexion and extension lateral radiographs.…”

Section: Introductionmentioning

confidence: 99%

“…With increasing resolution, MRI is a very useful tool in evaluating prognosis of several of these lesions. 4,5,[7][8][9]11,[13][14][15] It is the aim of this report to present the assessment and the surgical treatment of a 73-year-old man who presented initially with a complete cord syndrome after blunt cervical spine trauma and to focus the attention on MRI appearance of cord oedema as well as discoligamentous lesions with subsequent spinal instability.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Wenger

Pj²,

Alarcón³

et al. 2003

Spinal Cord

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Study design: A case report of blunt cervical spine trauma associated with cord oedema at the C3/C4 level with temporary Frankel/American Spinal Injury Association Grade A quadriparesis and motion segment instability without evidence of associated bony lesions (spinal cord injury without radiological abnormality, SCIWORA lesion). Objectives: By means of a rare and illustrative case, the reader's attention is focused on eventual marked cervical motion segment instability in SCIWORA patients. Setting: A department of Neurology in Quito, Ecuador and a department of Neurosurgery in Bern, Switzerland. Method: A 73-year-old man sustained blunt cervical spine trauma. After resolution of paraparesis, dynamic studies of the cervical spine revealed translational instability of C3 over C4. The patient underwent segment fusion by intervertebral cage insertion and plate fixation. Results: The patient had recovered almost completely from tetraparesis under conservative treatment. The postoperative course was uneventful. Solid bony fusion of the C3/C4 motion segment was obtained. Conclusion: Despite normal cervical alignment, the lack of bony lesions and neurological recovery, magnetic resonance imaging and dynamic studies may reveal marked translational cervical motion segment instability requiring segment fusion in order to prevent ongoing damage of the spinal cord.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Wenger

Pj²,

Alarcón³

et al. 2003

Spinal Cord

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Spatial and temporal evolution of hemorrhage in the hyperacute phase of experimental spinal cord injury: In vivo magnetic resonance imaging

Bilgen¹,

Abbe²,

Liu³

et al. 2000

Magn. Reson. Med.

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In vivo magnetic resonance imaging of the human cervical spinal cord at 3 Tesla

Korzan

Gorassini

Emery

et al. 2002

Magnetic Resonance Imaging

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Purpose:To demonstrate the feasibility of obtaining highquality magnetic resonance (MR) images of the human cervical spinal cord in vivo at a magnetic field strength of 3 T and to optimize the signal contrast between gray matter, white matter, and cerebrospinal fluid (CSF) on 2D gradient recalled echo (GRE) images of the cervical spinal cord. Materials and Methods:Using a custom-built, anatomically molded radio frequency (RF) surface coil, the repetition time and flip angle of a 2D GRE sequence were systematically varied in five volunteers to assess tissue contrast in the cervical spinal cord.Results: The 2D GRE parameters for an optimal balance between gray-white matter and CSF-white matter contrast at 3 T were determined to be a time-to-repetition (TR) of 2000 msec and a flip angle of 45°, with the constant short time-to-echo (TE) of 12 msec used in this study. Excellent tissue contrast and visualization of the internal anatomy of the spinal cord was demonstrated reproducibly in eight subjects using these optimal parameters. Conclusion:This study demonstrates that imaging the cervical spinal cord and delineating internal spinal cord structures such as gray and white matter is feasible at 3 T.

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Emergency Magnetic Resonance Imaging of Cervical Spinal Cord Injuries: Clinical Correlation and Prognosis

Abstract: Emergency MRI after spinal cord injury provides accurate prognostic information regarding neurological function and aids in the diagnosis and treatment of persistent spinal cord compression after vertebral realignment.

Cited by 124 publications

References 19 publications

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Traumatic cervical instability associated with cord oedema and temporary quadriparesis

Spatial and temporal evolution of hemorrhage in the hyperacute phase of experimental spinal cord injury: In vivo magnetic resonance imaging

In vivo magnetic resonance imaging of the human cervical spinal cord at 3 Tesla

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