Prognostic Value of Magnetic Resonance Imaging Markers in Predicting Neurological Outcomes in Traumatic Cervical Spinal Cord Injuries: An Observational Study

Objectives: The objectives of this study were to predict the prognostic value of conventional magnetic resonance imaging (MRI) parameters in predicting neurological outcomes in post-traumatic cervical spinal injuries (cord compression, cord oedema and cord haemorrhage) and to assess the neurological outcomes using the American Spinal Injury Association (ASIA) impairment scale. Materials and Methods: A total of 55 patients with traumatic cervical spinal cord injury (SCI) were recruited; history and neurological examination of the patient was done along with classifications of SCI according to ASIA after the assessment of vital parameters. MRI scan of cervical spine was done and certain parameters like presence or absence of haematoma, maximum spinal cord compression (MSCC), maximum canal compression (MCC) and lesion length were measured. Follow-up of neurological recovery was done on the 15th, 30th and 45th days and recorded in ASIA pro forma. Further to determine the correlation between MRI parameters and neurological recovery, Spearman rank correlation coefficient and multiple regression analysis were used. Results: Lesion length is statistically significant (P-value <0.05) for Asia Impairement Scale improvement at day 15, day 45, also significant for total sensory score and motor score on day 15 and shows significant for total sensory score on day 30, day 45. The presence of haematoma is statistically significant (P < 0.05) for total sensory score at day 30 and day 45, whereas MSCC and haematoma are statistically significant (<0.05) for total pinprick score at day 45. Discussion: Lesion length remains the most important predictor for neurological recovery after cervical spine trauma; however, haematoma and MSCC are potential predictors for neurological recovery and change in ASIA score. The study was registered at the Clinical Trials Registry-India (CTRI/2022/07/044163).