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Updated: Jul 12, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
MRI-defined compression stages and postoperative neurological recovery in thoracic spinal tuberculosis
Guangxuan Yan1, Weijie Dong1, Jun Fan1
1Department of Orthopaedics, Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Objectives:
Neurological impairment in thoracic spinal tuberculosis is often related to complex inflammatory and compressive lesions, while the reversibility of neurological deficits remains difficult to predict preoperatively.
Methods:
We retrospectively analyzed 148 patients with thoracic spinal tuberculosis who underwent surgical treatment between 2019 and 2025. Neurological recovery was defined as improvement in American Spinal Injury Association (ASIA) grade at follow-up. Preoperative MRI findings were evaluated according to the anatomical relationship between the compressive lesion, dural sac, and spinal cord, and categorized into four MRI-defined compression stages. Associations between MRI-defined compression stages and postoperative neurological recovery were assessed using logistic regression analysis.
Results:
Postoperative neurological recovery differed across MRI-defined compression stages. In multivariable analysis, MRI-defined compression stages remained independently associated with postoperative recovery (OR 2.87, 95% CI 1.87-4.75, P < 0.001). Compared with conventional clinical variables and quantitative MRI measurements, MRI-defined compression stages provided better discrimination of postoperative neurological recovery patterns. Although quantitative imaging parameters and clinical variables exhibited some degree of overlap across patient groups, MRI-based anatomical assessment provided additional clinically interpretable information beyond isolated quantitative measurements. These findings suggest that severe MRI compression does not necessarily indicate irreversible spinal cord injury.
Conclusion:
MRI-defined compression stages were significantly associated with postoperative neurological recovery in thoracic spinal tuberculosis. Severe MRI compression did not necessarily indicate irreversible neurological injury, suggesting that MRI-based anatomical assessment may complement neurological examination by facilitating preoperative risk stratification and identifying patients with potentially reversible spinal cord compromise.
