Spinal Cord Tissue Bridges Validation Study: Predictive Relationships With Sensory Scores Following Cervical Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2022 · DOI: 10.46292/sci21-00018 · Published: January 1, 2022

Spinal Cord Injury Neurology Medical Imaging

Simple Explanation

This study uses MRI to measure the width of spared tissue in the spinal cord after injury. These measurements, called tissue bridges, are taken on the ventral and dorsal sides of the lesion. The study found that wider ventral tissue bridges are linked to better pinprick sensation, and wider dorsal tissue bridges are linked to better light touch sensation. These MRI measurements could help doctors predict how well a person will recover sensory function after a spinal cord injury.

Study Duration

Not specified

Participants

136 participants post cervical level SCI

Evidence Level

Level 3, Retrospective Study

Key Findings

1
Wider ventral tissue bridges were significantly correlated with pinprick scores at discharge from inpatient rehabilitation (r = 0.31, p < 0.001, N = 136).
2
Wider dorsal tissue bridges were significantly correlated with light touch scores at discharge from inpatient rehabilitation (r = 0.31, p < 0.001, N = 136).
3
After controlling for age and dorsal tissue bridges, ventral tissue bridges significantly predicted total pinprick sensory score at discharge (β = 6.91, p = .048; 95% CI, 0.58, 13.76).

Research Summary

This retrospective study validated previous findings using a larger sample size (N = 136) to assess the relationship between tissue bridges and sensory scores following cervical spinal cord injury. The study found that wider ventral tissue bridges are significantly correlated with better pinprick scores, and wider dorsal tissue bridges are significantly correlated with better light touch scores at discharge from inpatient rehabilitation. The study concludes that these MRI-measured surrogates of spared neural tissue may be used, along with clinical examination, for prognosis of specific sensory recovery and patient stratification for prospective clinical trials.

Practical Implications

Prognostic Tool

MRI measurements of tissue bridges can be used as a prognostic tool to predict sensory recovery after SCI.

Patient Stratification

Tissue bridge measurements can help stratify patients into subgroups for targeted interventions and clinical trials.

Inform Diagnostic Workups

These findings can inform diagnostic workups and treatment plans for patients with spinal cord injuries.

Study Limitations

1
Mechanisms of injury were unavailable for this project, and this is an acknowledged limitation.
2
The correlation and first linear regression model demonstrated a slightly lower explanation of the variance in future pinprick score (R2 < 0.20) compared to the previous study (previously reported R2 = 0.385).
3
Although we are unsure of the exact reasons for our finding, it is possible that patients with SCI from this SCI Model Systems Center who are younger tend to have more severe, traumatic injuries compared to those who are older (unpublished data).

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