PURPOSE: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to correlate the MRI pattern with the neurological outcome. MATERIALS AND METHODS: Thirty-eight patients with MRI-proven spinal cord injury were classified according to the Frankel classification. MRI was always performed within 8 hours from trauma. Frankel classification divides spinal cord injuries into 5 classes of decreasing severity based on the presence of motor and/or sensory function loss. On the basis of the MRI findings the patients were classified in 3 groups: group 1 (intramedullary haematoma), group 2 (multi-metamer oedema), group 3 (single-metamer oedema). All patients underwent neurosurgery and were clinically evaluated until the stabilization of neurological recovery. Mean follow-up time was 12 months. The MR images were retrospectively evaluated and correlated to the neurological outcome. RESULTS: Twenty-eight patients showed complete motor loss (Frankel classes A and B); of these 28 patients 12 (42.8%) had MRI evidence of intramedullary haematoma, 12 (42.8%) had multi-metamer oedema and 4 (14.4%) had single-metamer oedema. Of the 10 patients with incomplete motor loss, none had MRI evidence of haemorrhage, 4 (40%) showed multi-metamer oedema and 6 (60%) showed single-metamer oedema. Follow-up clinical assessment revealed that 14/38 patients (36,8%) had clinical improvement and 2/38 cases (5%) had a complete motor recovery, as demonstrated by the move to a higher Frankel class. CONCLUSIONS: Our results, consistent with previous reports, confirm a strong correlation between the MRI appearance of traumatic spinal cord injuries in acute phase and long-term recovery of motor and sensory function: patients with initial haemorrhage had a poor prognosis, whereas those with spinal cord oedema had a good clinical outcome, as demonstrated by the passage to a higher Frankel class. MRI is particularly important in the initial evaluation of unconscious patients who cannot undergo a motor and sensory neurological evaluation, and to define the prognosis, which will influence the correct therapeutic choice.
PURPOSE: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to correlate the MRI pattern with the neurological outcome. MATERIALS AND METHODS: Thirty-eight patients with MRI-proven spinal cord injury were classified according to the Frankel classification. MRI was always performed within 8 hours from trauma. Frankel classification divides spinal cord injuries into 5 classes of decreasing severity based on the presence of motor and/or sensory function loss. On the basis of the MRI findings the patients were classified in 3 groups: group 1 (intramedullary haematoma), group 2 (multi-metamer oedema), group 3 (single-metamer oedema). All patients underwent neurosurgery and were clinically evaluated until the stabilization of neurological recovery. Mean follow-up time was 12 months. The MR images were retrospectively evaluated and correlated to the neurological outcome. RESULTS: Twenty-eight patients showed complete motor loss (Frankel classes A and B); of these 28 patients 12 (42.8%) had MRI evidence of intramedullary haematoma, 12 (42.8%) had multi-metamer oedema and 4 (14.4%) had single-metamer oedema. Of the 10 patients with incomplete motor loss, none had MRI evidence of haemorrhage, 4 (40%) showed multi-metamer oedema and 6 (60%) showed single-metamer oedema. Follow-up clinical assessment revealed that 14/38 patients (36,8%) had clinical improvement and 2/38 cases (5%) had a complete motor recovery, as demonstrated by the move to a higher Frankel class. CONCLUSIONS: Our results, consistent with previous reports, confirm a strong correlation between the MRI appearance of traumatic spinal cord injuries in acute phase and long-term recovery of motor and sensory function: patients with initial haemorrhage had a poor prognosis, whereas those with spinal cord oedema had a good clinical outcome, as demonstrated by the passage to a higher Frankel class. MRI is particularly important in the initial evaluation of unconscious patients who cannot undergo a motor and sensory neurological evaluation, and to define the prognosis, which will influence the correct therapeutic choice.
Authors: J Haefeli; M C Mabray; W D Whetstone; S S Dhall; J Z Pan; P Upadhyayula; G T Manley; J C Bresnahan; M S Beattie; A R Ferguson; J F Talbott Journal: AJNR Am J Neuroradiol Date: 2016-12-22 Impact factor: 3.825
Authors: Bizhan Aarabi; Charles A Sansur; David M Ibrahimi; J Marc Simard; David S Hersh; Elizabeth Le; Cara Diaz; Jennifer Massetti; Noori Akhtar-Danesh Journal: Neurosurgery Date: 2017-04-01 Impact factor: 4.654
Authors: Marc C Mabray; Jason F Talbott; William D Whetstone; Sanjay S Dhall; David B Phillips; Jonathan Z Pan; Geoffrey T Manley; Jacqueline C Bresnahan; Michael S Beattie; Jenny Haefeli; Adam R Ferguson Journal: J Neurotrauma Date: 2016-02-01 Impact factor: 5.269
Authors: Bizhan Aarabi; J Marc Simard; Joseph A Kufera; Melvin Alexander; Katie M Zacherl; Stuart E Mirvis; Kathirkamanthan Shanmuganathan; Gary Schwartzbauer; Christopher M Maulucci; Justin Slavin; Khawar Ali; Jennifer Massetti; Howard M Eisenberg Journal: J Neurosurg Spine Date: 2012-07-13
Authors: Hamdy Awad; Anna Bratasz; Gerard Nuovo; Richard Burry; Xiaomei Meng; Hesham Kelani; Melissa Brown; Mohamed E Ramadan; Jim Williams; Lamia Bouhliqah; Phillip G Popovich; Zhen Guan; Cynthia Mcallister; Sarah E Corcoran; Brian Kaspar; D Michele Basso; José J Otero; Claudia Kirsch; Ian C Davis; Carlo Maria Croce; Jean-Jacques Michaille; Esmerina Tili Journal: Ann Diagn Pathol Date: 2018-06-18 Impact factor: 2.090