Clinical and magnetic resonance imaging correlation in acute spinal cord injury

The aim of this study was to correlate traumatic spinal cord injury (SCI) patient's outcome with magnetic resonance imaging (MRI) performed within the first 15 days following trauma. We retrospectively analyzed 55 SCI patients. Upon admission, 28 were diagnosed as having a complete SCI (51%), versus 27 with an incomplete SCI (49%). All of the patients with a normal pattern on MRI (four cases), had an incomplete SCI, whereas all patients (15 cases) presenting with a hemorrhage pattern (Type 1) had a complete SCI (P = 0.0001). Fourteen of the 15 individuals (93.4%) with the edema pattern (Type II) had an incomplete SCI (P = 0.001), while the other patient had neurological deterioration, and a syrinx was noted 2 years later (6.6%). Among the 10 individuals showing a contusion pattern (Type III), seven were admitted with an incomplete SCI (70%) and three with a complete SCI (30%). The compression pattern tends to be associated with a complete SCI in 77.8% (seven of nine patients). All patients with a transection pattern on MRI (two cases) were clinically diagnosed as having a complete SCI. Early functional prognosis may be established on the basis of clinical presentation of SCI and associated MRI. Cord hemorrhage and transection are irreversible, while edema has a potential for neurological recovery. Cord contusion tends to be associated with an incomplete SCI, unlike the compression pattern, in which the prognosis depends on the degree of the initial neurological damage.