Correlation between MRI and DTI parameters in acute thoracic spinal cord injury and clinical outcomes: A prospective observational study.

STUDY

DESIGN

Prospective Observational Study.

OBJECTIVE

The current study aims to explore the correlation of MRI and DTI parameters in acute thoracic spinal cord injuries for prediction of neurological outcomes.

SETTING

University level tertiary care hospital of Northern India.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

LEVEL OF EVIDENCE: III.