Predictive Value of Midsagittal Tissue Bridges on Functional Recovery After Spinal Cord Injury

Neurorehabilitation and Neural Repair, 2021 · DOI: 10.1177/1545968320971787 · Published: January 1, 2021

Spinal Cord Injury Neuroimaging Rehabilitation

Simple Explanation

The study investigates whether the location and size of remaining tissue in the spinal cord after injury can predict how well a patient recovers. Researchers used MRI scans to measure these tissue bridges and then looked at how these measurements related to improvements in motor and sensory function. The findings suggest that larger tissue bridges, particularly in certain areas of the spinal cord, are linked to better recovery outcomes, helping to classify patients into different recovery potential groups.

Study Duration

12 months

Participants

70 patients with subacute SCI (56 men, age: 52.36 ± 18.58 years)

Evidence Level

Not specified

Key Findings

1
Larger ventral and dorsal tissue bridges were associated with higher AIS conversion rates 12 months post-SCI.
2
Ventral tissue bridges were predictors of 12-month total motor scores and recovery of upper extremity motor scores.
3
Dorsal tissue bridges at 1 month were predictors of 12-month Spinal Cord Independence Measure scores.

Research Summary

This study assessed the predictive value of midsagittal tissue bridges for American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade conversion and SCI patient stratification into recovery-specific subgroups. Larger ventral (P = .001, r = 0.511) and dorsal (P < .001, r = 0.546) tissue bridges were associated with higher AIS conversion rates 12 months post-SCI (n = 39). Midsagittal tissue bridges add predictive value to baseline clinical measures for post-SCI recovery and provide means to optimize patient stratification in clinical trials.

Practical Implications

Prognostic Tool

Midsagittal tissue bridges can be used as an imaging biomarker to predict the extent of functional recovery after SCI.

Patient Stratification

Tissue bridge width can help classify SCI patients into subgroups with distinct recovery profiles, which may improve clinical trial design.

Therapeutic Targets

Understanding the role of ventral and dorsal tissue bridges may inform targeted therapeutic interventions to promote tissue preservation or regeneration.

Study Limitations

1
More tetraplegic than paraplegic patients were included.
2
The clinical endpoints and some of the predictors used in this study represent ordinal variables.
3
Low spatial resolution of T2w axial slices did not allow quantification of lateral tissue bridges.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury