Jeffrey C Berliner1, Denise R O'Dell1,2, Stephanie R Albin2, David Dungan1,3, Mitch Sevigny1, James M Elliott4, Kenneth A Weber5, Daniel R Abdie2, Jack S Anderson2, Alison A Rich2, Carly A Seib2, Hannah G S Sagan2, Andrew C Smith2,6. 1. Craig Hospital, Englewood, Colorado, USA. 2. Regis University School of Physical Therapy, Denver, Colorado, USA. 3. Radiology Imaging Associates, Denver, Colorado, USA. 4. Faculty of Medicine and Health, The University of Sydney, Northern Sydney Local Health District, The Kolling Research Institute, St Leonards, Sydney, Australia. 5. Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA. 6. Department of Physical Medicine and Rehabilitation Physical Therapy Program, University of Colorado School of Medicine, Aurora, Colorado, USA.
Abstract
CONTEXT/ OBJECTIVE: Magnetic resonance imaging (MRI) indices of spinal cord damage are predictive of future motor function after spinal cord injury (SCI): hyperintensity length, midsagittal tissue bridges, and Brain and Spinal Injury Center (BASIC) scores. Whether these indices are predictive of outdoor walking after SCI is unknown. The primary purpose was to see if these MRI indices predict the ability to walk outdoors one-year after SCI. The secondary purpose was to determine if MRI indices provide additional predictive value if initial lower extremity motor scores are available. DESIGN: Retrospective. Clinical T2-weighted MRIs were used to quantify spinal cord damage. Three MRI indices were calculated: midsagittal ventral tissue bridges, hyperintensity length, BASIC scores. SETTING: Academic hospital. PARTICIPANTS: 129 participants with cervical SCI. INTERVENTIONS: Inpatient rehabilitation. OUTCOMES MEASURES: One year after SCI, participants self-reported their outdoor walking ability. RESULTS: Midsagittal ventral tissue bridges, hyperintensity length, and BASIC scores significantly correlated with outdoor walking ability (R = 0.34, P < 0.001; R = -0.25, P < 0.01; Rs = -0.35, P < 001, respectively). Using midsagittal ventral tissue bridges and hyperintensity length, the final adjusted R2 for model 1 = 0.19. For model 2, the adjusted R2 using motor scores alone = 0.81 and MRI variables were non-significant. All five participants with observable intramedullary hemorrhage reported they were unable to walk one block outdoors. CONCLUSIONS: The MRI indices were significant predictors of outdoor walking ability, but when motor scores were available, this was the strongest predictor and neither midsagittal tissue bridges nor hyperintensity length contributed additional value. MRI indices may be a quick and convenient supplement to physical examination when motor testing is unavailable.
CONTEXT/ OBJECTIVE: Magnetic resonance imaging (MRI) indices of spinal cord damage are predictive of future motor function after spinal cord injury (SCI): hyperintensity length, midsagittal tissue bridges, and Brain and Spinal Injury Center (BASIC) scores. Whether these indices are predictive of outdoor walking after SCI is unknown. The primary purpose was to see if these MRI indices predict the ability to walk outdoors one-year after SCI. The secondary purpose was to determine if MRI indices provide additional predictive value if initial lower extremity motor scores are available. DESIGN: Retrospective. Clinical T2-weighted MRIs were used to quantify spinal cord damage. Three MRI indices were calculated: midsagittal ventral tissue bridges, hyperintensity length, BASIC scores. SETTING: Academic hospital. PARTICIPANTS: 129 participants with cervical SCI. INTERVENTIONS: Inpatient rehabilitation. OUTCOMES MEASURES: One year after SCI, participants self-reported their outdoor walking ability. RESULTS: Midsagittal ventral tissue bridges, hyperintensity length, and BASIC scores significantly correlated with outdoor walking ability (R = 0.34, P < 0.001; R = -0.25, P < 0.01; Rs = -0.35, P < 001, respectively). Using midsagittal ventral tissue bridges and hyperintensity length, the final adjusted R2 for model 1 = 0.19. For model 2, the adjusted R2 using motor scores alone = 0.81 and MRI variables were non-significant. All five participants with observable intramedullary hemorrhage reported they were unable to walk one block outdoors. CONCLUSIONS: The MRI indices were significant predictors of outdoor walking ability, but when motor scores were available, this was the strongest predictor and neither midsagittal tissue bridges nor hyperintensity length contributed additional value. MRI indices may be a quick and convenient supplement to physical examination when motor testing is unavailable.
Entities:
Keywords:
MRI; Magnetic resonance imaging; SCI; Spinal cord injury; Walking
Authors: Andrew C Smith; Denise R O'Dell; Wesley A Thornton; David Dungan; Eli Robinson; Ashesh Thaker; Robyn Gisbert; Kenneth A Weber; Jeffrey C Berliner; Stephanie R Albin Journal: Top Spinal Cord Inj Rehabil Date: 2021-11-24
Authors: Candace Tefertiller; Meghan Rozwod; Eric VandeGriend; Patricia Bartelt; Mitch Sevigny; Andrew C Smith Journal: Front Rehabil Sci Date: 2022-01-04
Authors: Andrew C Smith; Denise R O'Dell; Stephanie R Albin; Jeffrey C Berliner; David Dungan; Eli Robinson; James M Elliott; Julio Carballido-Gamio; Jennifer Stevens-Lapsley; Kenneth A Weber Journal: Arch Phys Med Rehabil Date: 2021-08-08 Impact factor: 3.966