Evaluation of Traumatic Spine by Magnetic Resonance Imaging and Correlation with Neurological Recovery.
Evaluation of Traumatic Spine by Magnetic Resonance Imaging and Correlation with Neurological Recovery.
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DOI：
10.4184/asj.2015.9.5.748
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发表时间：
2015-10
影响因子：
2.3
通讯作者：
Bala M
中科院分区：
文献类型：
--
作者：
Magu S;Singh D;Yadav RK;Bala M
前瞻性研究。将磁共振成像 (MRI) 结果与患者的临床特征和神经系统状态进行比较，并将 MRI 结果与患者的神经系统恢复相关联并预测结果。先前的研究报告称，与脊柱损伤患者的脊髓水肿相比，脊髓出血患者的神经功能恢复较差。高位根管受损、脊髓受压以及更严重的脊髓损伤也带来较差的预后价值。根据美国脊柱损伤协会（ASIA）损伤量表，在入院和出院时评估患者的神经状态。平均住院时间为 14.11±5.74 天。将入院时的神经系统状态和出院时的神经系统恢复情况与 MRI 上的各种定性脊髓检查结果和定量参数进行比较。对27名患者进行了长期随访，平均时间为285.9±43.94天，比较相同的参数。脊髓水肿和正常脊髓与良好的神经系统结果相关。与脊髓水肿相比，脊髓挫伤的神经功能恢复较差。脊髓出血与入院时最差的神经状态和神经恢复不良有关。患有 ASIA A 损伤量表损伤的患者的平均管损伤 (MCC)、平均脊髓受压 (MSCC) 和病变长度值较高，而 ASIA E 损伤量表损伤呈下降趋势。与未显示神经功能恢复的患者相比，显示神经功能恢复的患者具有较低的平均 MCC、MSCC 和病变长度 (p<0.05)。脊髓出血、较高的 MCC、MSCC 和病变长度值对脊柱损伤患者的预后价值较差。
Prospective study. To compare magnetic resonance imaging (MRI) findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patients and predict the outcome. Previous studies have reported poor neurological recovery in patients with cord hemorrhage, as compared to cord edema in spine injury patients. High canal compromise, cord compression along with higher extent of cord injury also carries poor prognostic value. Neurological status of patients was assessed at the time of admission and discharge in as accordance with the American Spine Injury Association (ASIA) impairment scale. Mean stay in hospital was 14.11±5.74 days. Neurological status at admission and neurological recovery at discharge was compared with various qualitative cord findings and quantitative parameters on MRI. In 27 patients, long-term follow-up was done at mean time of 285.9±43.94 days comparing same parameters. Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion showed lesser neurological recovery, as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length values were higher in patients presenting with ASIA A impairment scale injury and showed decreasing trends towards ASIA E impairment scale injury. Patients showing neurological recovery had lower mean MCC, MSCC, and lesion length, as compared to patients showing no neurological recovery (p<0.05). Cord hemorrhage, higher MCC, MSCC, and lesion length values have poor prognostic value in spine injury patients.