Prediction of Prognosis in Patients With Cervical Spinal Cord Injury Without Radiologic Evidence of Trauma Using MRI

Full article available online at Healio.com/Orthopedics. Search: 20140225-65 The purpose of this study was to investigate whether preto postoperative changes of increased signal intensity (ISI) of the spinal cord as seen on T2-weighted magnetic resonance imaging (MRI) reflect the surgical outcome in patients with cervical spinal cord injury without radiologic evidence of trauma (SCIWORET). In this study, 54 patients with SCIWORET who underwent expansive laminoplasty were retrospectively analyzed. All patients underwent MRI at an average of 1.9 days (range, 1-5 days) after injury and 7.9 days (range, 6-10 days) postoperatively. The preand postoperative range and degree of ISI were measured on computer software using the same sagittal view on T2-weighted MRI. Then, the post-preoperative ratio of range and degree of ISI were calculated. Preand postoperative neurologic evaluations were performed according to the criteria proposed by the Japanese Orthopedic Association (JOA). A significant negative correlation existed between the ratio of range of ISI and the recovery rate (r=-0.504, P 1 (n=30). Patients’ mean recovery rate was 65.0%±6.3% in group A and 52.4%±7.4% in group B. A significant difference was found between the 2 groups (P<.001, Student’s t test) when comparing recovery rate. The preto postoperative changes of the range and degree of ISI significantly reflected prognosis for surgical outcome in patients with SCIWORET. The authors are from the Department of Spine Surgery (L-QS, YS, J-MC), The Third Hospital of Hebei Medical University, Shijiazhuang; and the Department of Spine Surgery (L-QS, Y-ML), The Second Hospital of Tangshan, Tangshan, China. The authors have no relevant financial relationships to disclose. Correspondence should be addressed to: Yong Shen, MD, Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, Hebei 050051, China (ts_sunlaiqing @163.com). Received: June 11, 2013; Accepted: October 11, 2013; Posted: March 11, 2014. doi: 10.3928/01477447-20140225-65 Prediction of Prognosis in Patients With Cervical Spinal Cord Injury Without Radiologic Evidence of Trauma Using MRI Lai-Qing Sun, MD; Yong Shen, MD; Yong-Min Li, MD; Jun-Ming Cao, MD Figure: Preoperative sagittal T2-weighted magnetic resonance imaging showing the range and degree of increased signal intensity. Abbreviations: DISI, degree of increased signal intensity; RISI, range of increased signal intensity.