Publication:

Diagnostic and prognostic role of magnetic resonance imaging in spinal trauma, and correlation with clinical profile

Background Trauma is a common and devastating insult to the spine and spinal cord with important long-term sequelae for the individual. Diagnostic imaging, particularly Magnetic Resonance Imaging (MRI), plays a crucial role in evaluating and detecting spinal trauma. MRI is not only a diagnostic tool in spinal trauma but also a prognostic predictor. It is possible to predict the neurological outcome of the patients with different cord abnormalities. The objective of this study is to enumerate the cord findings in MRI in patients with spinal trauma and to correlate the findings with clinical profile and neurological outcome of the patients.

Methods A total of 50 cases of spinal trauma over a period of 1 year were included in the study. MRI of spine performed in patients with spinal trauma to see the cord findings. Detailed motor and sensory examination of the patient on admission and discharge was done and graded according to American Spinal Injury Association Scale (ASIA). Chi square test of significance (p<0.005) was used to assess the association between MR findings and clinical outcome.

Results In the study we observed that patients with cord haemorrhage and large cord oedema had initial high grade AIS and less chance of recovery with vice versa. Patients with presence of focus of haemorrhage had more severe grade of initial ASIA than those without haemorrhage with significantly more chances of retaining complete injury at follow up. Patients with edema less than 3cm improved on follow up examination.

Conclusions MRI is an excellent modality of imaging in the diagnosis of cord abnormalities in spinal trauma. The cord findings correlate with the neurological deficit of the patient on admission and discharge.