The Relationship between the Functional Abilities of Patients with Cervical Spinal Cord Injury and the Severity of Damage Revealed by MR Imaging

AJNR Am J Neuroradiol, 1999 · DOI: · Published: May 1, 1999

Spinal Cord Injury Neuroimaging Rehabilitation

Simple Explanation

This study investigates the relationship between spinal cord damage seen on MRI scans and the functional recovery of patients with cervical spinal cord injuries. The study focuses on how spinal cord hemorrhage and edema (swelling) affect a patient's ability to perform daily tasks after a spinal cord injury. The findings suggest that the presence of hemorrhage, longer areas of edema, and injuries higher up on the cervical spine are linked to poorer functional recovery.

Study Duration

5 years

Participants

49 patients with cervical SCI

Evidence Level

Not specified

Key Findings

1
Patients without spinal cord hemorrhage showed significantly greater improvement in self-care and mobility scores compared to those with hemorrhage.
2
The upper (rostral) limit of edema positively correlated with self-care scores at admission and discharge, as well as mobility and locomotion scores at admission.
3
The length of edema negatively correlated with all functional independence measure (FIM) scales at both admission and discharge, indicating worse function with longer edema.

Research Summary

The study examined the relationship between MR imaging findings of cervical spinal cord injury (SCI) and the recovery of functional motor skills, as measured by the functional independence measure (FIM). The presence of spinal cord hemorrhage was associated with significantly less improvement in self-care and mobility scores, while the rostral limit of edema correlated positively with functional scores, and edema length correlated negatively. The study concludes that imaging characteristics such as hemorrhage and edema are related to physical recovery levels, with hemorrhage, long segments of edema, and high cervical locations correlating with poor functional recovery.

Practical Implications

Prognostic Tool

MR imaging can be used as a prognostic tool to gauge the potential for recovery in cases of SCI.

Rehabilitation Programs

Subsets of patients could be selected for more aggressive rehabilitation programs based on initial MR study results.

Predictive Factors

High-cervical hemorrhagic lesions are predictive of complete dependence, while low-cervical nonhemorrhagic lesions suggest a modified dependence.

Study Limitations

1
Small patient cohort
2
Inability to control for the variable length of stay in rehabilitation
3
Unable to control for the potential effects of surgical stabilization and medical therapies on FIM scores

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