MRI Prognostication in Cervical Spinal Cord Injury without Discocorporeal Injury

Abstract

MRI has emerged as the most important imaging modality in the evaluation of spinal cord injury. Its importance in the diagnosis and prognostication has been well established. We retrospectively studied the MRI appearances of 29 patients with cervical spinal cord injury without radiologically demonstrable fracture or dislocation of the cervical spine. All patients were adults, who presented with varying grades of cervical myelopathy following trauma; eight of these were elderly with stenotic spinal canals due to cervical spondylosis. Neurological function and MRI appearances were correlated. The presence and rostrocaudal extent of intraaxial hematoma, extrinsic stenotic compression of spinal cord were each significantly associated with poor neurological function at presentation and in long-term follow-up examinations. Although the best single predictor of long-term improvement in neurological function was the neurological grade at the time of presentation, the presence and extent of intraaxial spinal cord hematoma and the presence of spinal cord compression provided significant additional information. MRI provides accurate diagnostic and prognostic information regarding neurological function and aids in treatment planning in cervical spinal cord injury without accompanying skeletal injury.

Keywords

cervical spine - magnetic resonance imaging - quadriplegia - spinal injury

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