Magnetic resonance imaging in acute cervical spinal cord injury: a correlative study on spinal cord changes and 1 month motor recovery

Study Design: Retrospective study. Objectives: We aimed to correlate the spinal cord changes as depicted by magnetic resonance imaging (MRI) with the neurological deficit and motor recovery of patients with acute cervical spinal cord injury (SCI). Setting: A total of 57 patients with acute cervical spine trauma who presented to the Department of Radio Diagnosis, Kasturba Medical College Manipal, Karnataka, India, over a period of 5 years ( August 2002 to September 2007) were studied. Methods: The pattern and extent of spinal cord changes on MRI were compared with the American Spinal Injury Association (ASIA) grade, motor index score (MIS) and the total number of useful muscles in the extremities on admission (ADM) and follow-up. The differences in the recovery rates (RR) among patients with cord edema (EDE), contusion and hemorrhage (HGE) were tested statistically. Results: Spinal cord edema was associated with a better neurological outcome than contusion or hemorrhage, and its overall length showed a negative correlation with the recovery rate (P = 0.001). Conclusion: MRI is invaluable in evaluating cervical SCI. Cord edema is associated with a better neurological outcome when compared with cord contusion or hemorrhage.