Prospective evaluation of relationship between MRI findings and ASIA score to predict neurological recovery in acute traumatic spinal cord injury

• Main Authors: Roop Singh (Author), Vijay Singh Meena (Author), Pankaj Sharma (Author), Kiranpreet Kaur (Author), Svareen (Author)
• Format: Book
• Published: International Journal of Spine Research - Peertechz Publications, 2020-04-06.
• Subjects: Research Article
• Online Access: Connect to this object online.

<p>Introduction: The role of MRI in evaluating the acutely injured spine is well established and contributes to assessment of ligamentous disruption, associated disc protrusions as well as exact site of maximal canal stenosis and nature of cord injury; and neurological assessment as per ASIA score is an internationally accepted method. It is not well established the MRI at any point of time correlates with ASIA score to prognosticate neurological recovery.</p><p>Aims: The present study aimed to evaluate relationship between MRI findings and ASIA score to predict neurological deficit and recovery in acute SCI patients.</p><p>Methods: Thirty-five patients of acute spinal cord injury with mean age of 31.34 ± 10.63 years (range 16 to 65 years), who have been presented within 48 hours of injury were included in the study. Complete neurological (ASIA grading) and MRI examinations were done at presentation, 3 months, and 6 months to evaluate the SCI. Statistical analysis of MRI (qualitative & quantitative) findings and clinical evaluation was done with ASIA scoring to find an agreement between MRI and neurological outcome.</p><p>Results: The statistically significant correlation was found to be with Maximum Canal Compromise (MCC) (-0.703) followed by lesion length (-0.678), Maximum Spinal Cord Compression (MSCC) (-0.661), stenosis (-0.577) and disc herniation (-0.420) to prognosticate the neural recovery as determined by ASIA score. The rest of MRI findings didn't have significant correlation with ASIA score at any point of time. However, decrease in edema significantly correlated with ASIA score at 3 and 6 months post injury. Statistically significant kappa agreement between neurological recovery diagnosed by ASIA score and MRI findings was found with MCC (k=0.211) and soft tissue injury (k=0.318).</p><p>Conclusions: The present study showed that significant correlation exist between MRI findings (MCC, MSCC, stenosis, and disc herniation) and ASIA score at different point of time post SCI. Furthermore, statistically significant kappa agreement between neurological recovery diagnosed by ASIA score and MRI findings (MCC and soft tissue injury) was found. We suggest that serial neurologic examination and neuroimaging complement each other in prognosticating neurological recovery after acute traumatic SCI.</p>