Verma Vishal, Regmi Anil, Jain Aakash, Shekhar Sethy Siddharth, Kandwal Pankaj, Sarkar Bhaskar
Department of Orthopedics, AIIMS, Rishikesh, Uttarakhand, 249203, India.
Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, 249203, India.
J Clin Orthop Trauma. 2025 Mar 13;66:102975. doi: 10.1016/j.jcot.2025.102975. eCollection 2025 Jul.
Prospective Observational Study.
The current study aims to explore the correlation of MRI and DTI parameters in acute thoracic spinal cord injuries for prediction of neurological outcomes.
University level tertiary care hospital of Northern India.
Conventional MRI and DTIs were performed for 51 acute thoracic spinal cord injury patients. The relationship of MRI and DTI parameters with preoperative and postoperative AIS motor and sensory scores in complete and incomplete neurological deficit groups were done. AIS score, AO PROST Score and ODI score was used for neurological and functional assessment of spinal cord functions. Patients were divided into group I (ASIA A) and Group II (ASIA B, C, D). MRI and DTI parameters were compared between groups for their predictive value on neurology at admission and at final follow up.
Out of 20 patients in group I, 3 patients recovered by grade 1 and 6 patients by grade 2 and no recovery in 11 patients. In group II out of 31 patients 10 patients (33.4 %) recovered to ASIA E neurology. On Univariate analysis MOCC, SCC, Length of Cord swelling, LOE, Distortion index, Type of injury and Hematomyelia were significantly associated with complete neurological deficit at presentation. However, on final follow up, MOCC, SCC, Length of cord edema, and Hematomyelia were significant in predicting neurology.
Maximum osseous canal compromise, Spinal Cord Compression, Length of Edema, Length of Spinal cord swelling, and hematomyelia are best correlated with prediction of a neurological deficit. DTI also provides superior spinal cord imaging but faces technical challenges.
III.
前瞻性观察性研究。
本研究旨在探讨急性胸段脊髓损伤中MRI和DTI参数与神经功能预后预测的相关性。
印度北部大学三级护理医院。
对51例急性胸段脊髓损伤患者进行常规MRI和DTI检查。分析了MRI和DTI参数与完全性和不完全性神经功能缺损组术前和术后AIS运动及感觉评分的关系。采用AIS评分、AO PROST评分和ODI评分对脊髓功能进行神经学和功能评估。患者分为I组（ASIA A级）和II组（ASIA B、C、D级）。比较两组间MRI和DTI参数在入院时和最终随访时对神经学的预测价值。
I组20例患者中，3例恢复1级，6例恢复2级，11例未恢复。II组31例患者中，10例（33.4%）恢复至ASIA E级神经功能。单因素分析显示，MOCC、SCC、脊髓肿胀长度、LOE、变形指数、损伤类型和脊髓内出血与就诊时的完全性神经功能缺损显著相关。然而，在最终随访时，MOCC、SCC、脊髓水肿长度和脊髓内出血对神经功能的预测具有显著性。
最大骨性椎管狭窄、脊髓压迫、水肿长度、脊髓肿胀长度和脊髓内出血与神经功能缺损的预测相关性最佳。DTI也能提供更好的脊髓成像，但面临技术挑战。
III级。
