Heterogeneity among traumatic spinal cord injuries at the thoracolumbar junction: helping select patients for clinical trials

This study focuses on spinal cord injuries (SCIs) that occur at the thoracolumbar junction, which is a common site for spinal trauma. The researchers aimed to understand the different types of injuries that can occur in this area. The study categorized SCIs into five groups based on the completeness of the injury, the level of injury, and MRI findings. This detailed classification helps to account for the heterogeneity (variability) of these injuries. The findings emphasize the importance of considering the specific type of SCI when selecting patients for clinical trials. This is because different types of injuries may respond differently to treatments.

• 1
  The study identified five distinct categories of SCIs at the thoracolumbar junction: pure complete epiconus lesion with caudal cord intact (G1), complete epiconus injury with conus medullaris (CM) totally involved in the lesion (G2), CM syndrome, cauda equine syndrome without sacral sparing (G3 and G4), and incomplete injury (G5).
• 2
  Patients in the G2 group (complete epiconus injury with CM involvement) are often misidentified as G1, but they have different neurological deficits and complications.
• 3
  The study found that bladder capacity and residual urine volumes were significantly lower in G1 patients compared to G2, G3, and G4 patients, while the inverse was true for the IVPmax.