The value of magnetic resonance imaging (MRI) in the follow-up management of spinal injury.

Twenty-seven patients with spinal injury have been studied with follow-up Magnetic Resonance Imaging (MRI). MRI has helped (a) to determine the extent of cord injury; (b) to detect continuing compression to the spinal cord; (c) to discover unexpected pathologies and most importantly (d) to detect the development of post traumatic syrinx. MRI was most valuable in patients with post-traumatic syrinxes to evaluate any changes in the size, and, in those who had a shunting procedure, to assess the efficacy of the procedure. MRI also aided in planning complicated one stage operations by giving a 'complete' picture of the injury inflicted to the vertebrae, soft tissue structures and the spinal cord. As well as advantages in clinical audit it makes financial sense. It provides more information than CT myelography and is non-invasive. When compared to the cost of neurological deterioration it is much more cost effective to follow-up spinal injury patients with MRI. It is the authors' contention that after the acute phase all patients with spinal injury should have at least one MRI.