MRI can predict neurological recovery after spinal cord injury

Spinal cord injury (SCI) is a permanent, debilitating condition that often causes long-term neurological deficits—such as cognitive impairments, loss of motor control, memory problems, and loss of other basic functions that can significantly reduce an individual’s quality of life. To ensure that patients receive high-quality care, clinicians need to quickly determine the likelihood of neurological recovery after SCI. Accurate recovery predictions help clinicians to develop targeted, tailored interventions for each of their SCI patients.

A recent Canadian study investigated magnetic resonance imaging (MRI) as a tool for predicting neurological recovery after SCI. MRI uses a magnetic field to create detailed images of tissues and organs, which can include the brain, nervous system, and spinal cord. Using this imaging technology, a research team scanned 82 patients who sustained SCI between 2010 and 2017. They analyzed the images to determine three factors that may predict neurological recovery: the size of the injury, the presence of bleeding in the spinal cord, and spinal cord compression.

Next, they compared these three MRI parameters to a series of neurological assessments that measured the patients’ motor function and overall impairment, such as the American Spinal Injury Association (ASIA) Impairment Scale. Administered upon admission to the emergency department, the ASIA Impairment Scale is a standardized examination used to assess the degree of sensory and motor impairment following SCI, with possible results ranging from “completely normal” function to “total loss” of function. These results help rehabilitation teams develop realistic goals for patients recovering from SCI.

After analyzing the MRI scans, the research team found that both larger injuries and bleeding in the spinal cord predicted poor neurological outcomes and reduced the likelihood of neurological recovery from SCI. However, they found that these MRI results were not useful compared to results from the initial ASIA Impairment Scale. Accordingly, the researchers determined that although MRI has some predictive benefits, a patient’s initial neurological status remains the best predictor of long-term recovery outcomes.

Martineau J, Goulet J, Richard-Denis A, & Mac-Thiong JM. The relevance of MRI for predicting neurological recovery following cervical traumatic spinal cord injury. Spinal Cord. (2019).

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