PROGNOSTIC VALUE OF MAGNETIC RESONANCE IMAGING FINDINGS IN ACUTE SPINAL TRAUMA

AIM To assess the prognostic value of MRI findings in acute spinal trauma by assessing the neurological outcome after an interval period (3-4 months) and correlating it with the different MRI patterns of injury. METHODOLOGY Sixty patients with acute spinal trauma presenting to Calicut Medical College with neurological deficit for MR imaging were included in the study after applying the inclusion and exclusion criteria. MRI imaging of the spine was done and patients were divided into three groups based on the MR imaging pattern of cord injury (single level oedema, multi-level oedema, and cord haemorrhage). Neurological status of the patients were assessed at the time of presentation and at the followup period. Neurological outcome was categorised into good, fair, and poor based on the change in neurological status over the followup period. RESULTS AND INTERPRETATION In the study population, frequency of Spinal Cord Injury (SCI) was more common in males (90%) compared to females (10%). Majority of the patients belonged to the 20-60 years age group with highest incidence in 41-60 year age group and less number of patients at extremes of age. Most common cause was found to be road traffic accident followed by fall, assault, and sports injury. Cervical cord was the most commonly affected in traumatic injuries of the spine. There was statistically significant association between PLL injury and neurologic outcome. Statistically significant association was found between the neurologic outcome and the abnormal MRI signal patterns of cord injury. CONCLUSIONS MRI is useful for not only for initial diagnosis of acute spinal cord injury, but also for its prognostication and predicting neurological recovery.