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The relevance of MRI for predicting neurological recovery following cervical traumatic spinal cord injury

Résumé Study design Retrospective cohort study of 82 patients with cervical traumatic spinal cord injury (TSCI). Objectives Determine the relevance of preoperative MRI to predict neurological recovery following cervical TSCI. Setting Level I trauma center specialized in TSCI. Methods The following three MRI parameters were assessed: presence of an intramedullary hemorrhage, intramedullary lesion length and maximal compression of the spinal cord compression (MSCC). Analyses were performed to assess the relationship between MRI parameters and three neurological outcomes: ASIA motor score (AMS), improvement by at least one ASIA impairment scale (AIS) grade (conversion of AIS grade), and reaching AIS grade D or E. Results Predicting AMS based on initial AIS grade and intramedullary hemorrhage resulted in a validation R-squared of 0.662, and of 0.636 when using only the initial AIS grade. Predicting conversion of AIS grade based on initial AIS grade, intramedullary hemorrhage and lesion length resulted in a validation c-index of 0.704, and of 0.727 when using only the initial AIS grade. Predicting the likelihood of a follow-up AIS grade D or E based on initial AIS grade and intramedullary hemorrhage in a validation c-index of 0.903, and of 0.873 when using only the initial AIS grade. Conclusions Intramedullary hemorrhage and lesion length assessed from preoperative MRI were predictors of the neuro- logical recovery following cervical TSCI. However, the clinical benefit of these MRI parameters to predict the neurological recovery remains limited when the initial AIS grade is available, confirming that the initial neurological status remains the most important predictor of the neurological outcome.
AuteursJoanie Martineau, Julien Goulet, Andréane Richard-Denis, Jean-Marc Mac-Thiong
Titre de revue/journal, volume et numéroSpinal Cord, volume 57.
Langue de la publication et/ou de traductionAnglais (langue d’origine)
Année de parution2019
PaysQuébec, Canada.
Institutions affiliéesHôpital Sacré-Coeur, Université de Montréal
Lien vers la publicationhttps://www.nature.com/articles/s41393-019-0295-z
Type d’accès à la publicationGratuit
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Précédent The impact of a specialized spinal cord injury center as compared with non-specialized centers on the acute respiratory management of patients with complete tetraplegia: an observational study
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