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Updated: Jul 8, 2026
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Can MRI findings predict the outcome of cervical spinal cord Injury? a systematic review
Ahmad M Tarawneh1, Daniel D'Aquino2, Aaron Hilis2
1Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. neurostarawneh@hotmail.com.
Introduction:
MRI is the established gold standard for imaging acute spinal cord injury (SCI). Our aim was to identify the prognostic value, in terms of neurological outcome, of extradural and intradural features detected on MRI performed acutely following traumatic cervical SCI.
Materials And Methods:
Several databases were systematically searched to identify potentially eligible articles until December 2019. Using a standard PRISMA template, 2606 articles were initially identified.
Results:
A final 6 full-text articles met the inclusion criteria and were analyzed. An extradural factor, namely the maximal spinal cord compression, was associated with poor neurological outcome and statistically significant (P = 0.02 and P = 0.001 in 2 out of 3 studies). The intradural factors of length of the cord edema (P = 0.001, P = 0.006, and P < 0.001 in 3 studies), intramedullary hemorrhage (P = 0.002, P < 0.001, P < 0.001, and P = 0.002 in 4 studies), and the length of intramedullary hemorrhage (P = 0.028, P = 0.022 in 2 studies) also significantly correlated with poor neurological recovery at follow-up.
Conclusion:
While early MRI is established as a gold standard imaging of acute spinal trauma, it also serves to provide prognostic value on the neurological recovery. From our systematic review, there is a strong association of the extradural finding of maximal spinal cord compression, intradural MRI findings of length of cord edema, intramedullary hemorrhage, and length of intramedullary hemorrhage with neurological recovery in traumatic cervical spinal cord injuries.
Level Of Evidence:
III.
Insights
Early MRI in spinal cord injury (SCI) predicts neurological recovery. Maximal spinal cord compression, cord edema, and intramedullary hemorrhage on MRI are associated with poor outcomes in traumatic cervical SCI.
Area of Science:
- Neurosurgery
- Radiology
- Neurology
Background:
- Magnetic Resonance Imaging (MRI) is the gold standard for imaging acute spinal cord injury (SCI).
- Accurate prognostication of neurological outcome is crucial for managing patients with traumatic cervical SCI.
- Identifying prognostic indicators on acute MRI can guide clinical decision-making and patient counseling.
Purpose of the Study:
- To determine the prognostic value of extradural and intradural MRI findings in predicting neurological outcome after acute traumatic cervical SCI.
- To systematically review existing literature on MRI features and their correlation with neurological recovery.
Main Methods:
- A systematic literature search was conducted across multiple databases up to December 2019.
- PRISMA guidelines were followed for study selection and identification.
- Six full-text articles meeting the inclusion criteria were analyzed for prognostic MRI findings.
Main Results:
- Maximal spinal cord compression (extradural) was significantly associated with poor neurological outcome (P=0.02, P=0.001).
- Intradural findings including length of cord edema (P≤0.001), intramedullary hemorrhage (P≤0.001), and length of intramedullary hemorrhage (P=0.028, P=0.022) also correlated with poor neurological recovery.
- These findings were statistically significant across multiple studies.
Conclusions:
- Acute MRI in traumatic cervical SCI not only aids in diagnosis but also provides significant prognostic information.
- Extradural spinal cord compression and intradural findings such as cord edema and intramedullary hemorrhage are strong predictors of poor neurological recovery.
- These MRI markers can enhance the prediction of neurological outcomes in patients with acute cervical SCI.
