The influence of conventional T2 MRI indices in predicting who will walk outside one year after spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1907676 · Published: May 1, 2023

Spinal Cord Injury Medical Imaging Rehabilitation

Simple Explanation

This study investigated whether MRI scans taken after a spinal cord injury (SCI) can predict a person's ability to walk outside one year later. Specifically, it looked at hyperintensity length, midsagittal tissue bridges, and BASIC scores from the MRI scans. The study also examined if these MRI measures provide additional predictive power when combined with initial lower extremity motor scores, which are commonly used to assess motor function after SCI. The findings suggest that while MRI indices can predict outdoor walking ability, the initial motor scores are a stronger predictor if available. MRI might be a useful alternative when motor testing isn't possible.

Study Duration

One year

Participants

129 participants with cervical SCI

Evidence Level

Retrospective study

Key Findings

1
Midsagittal ventral tissue bridges, hyperintensity length, and BASIC scores significantly correlated with outdoor walking ability.
2
MRI indices were significant predictors of outdoor walking ability, but when motor scores were available, this was the strongest predictor.
3
All five participants with observable intramedullary hemorrhage reported they were unable to walk one block outdoors.

Research Summary

The study aimed to determine if MRI indices of spinal cord damage can predict outdoor walking ability one year after SCI and if they provide additional predictive value when initial motor scores are available. The results showed that MRI indices correlated with outdoor walking ability, but initial motor scores were the strongest predictor when available, with MRI adding little additional value. The study concludes that MRI measures may be a helpful supplement to physical examination when motor testing is unavailable or contraindicated.

Practical Implications

Clinical Prediction

MRI indices can serve as a supplementary tool to predict walking ability post-SCI, especially when motor function cannot be readily assessed.

Rehabilitation Planning

Understanding the predictive value of MRI in conjunction with motor scores can help tailor rehabilitation therapies and set realistic walking goals for SCI patients.

Future Research

Further investigation with standardized, high-resolution MRIs and inclusion of a broader range of clinical and imaging variables is warranted to enhance predictive models.

Study Limitations

1
The mechanisms of injury were unavailable for this project and this is an acknowledged limitation.
2
Another limitation to note is the lack of standardized, high-resolution MRIs collected at distinct time-points across participants.
3
A limitation of our study is that we chose to focus on the predictive value of T2-weighted signal hyperintensity measures of cord damage.

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