Advances in imaging of spinal cord injury: implications for treatment and patient evaluation

Close inspection of MR images in all stages of SCI can reveal alterations which are important for our understanding of the changes which occur in SCI and may be crucial for planning surgical intervention. Importantly also, these observations may assist in the evaluation of novel therapies in SCI, such as cellular transplantation. It is hopeful that MR strategies which are currently in routine use in the brain, such as diffusion weighted imaging, perfusion studies, spectroscopy, and magnetization transfer can be adopted for use in the spine (Schwartz et al., 1999b). Because of the small size of the cord, the magnetic suspectability problems caused by surrounding air and bone, and nearby vascular and CSF flow/pulsations, these techniques are currently very difficult to employ in the cord. They will, however, evolve over time and give us greater insights into the in vivo status of the injured cord.