Role of Magnetic Resonance Imaging in Spinal Cord Traumatic Injuries and its outcome according to ASIA Impairment Scale

Abstract

Background: Spinal trauma is one of common neurosurgical problem and mismanagement can lead to fatal outcome. Objective: To determine the MRI based initial diagnosis of acute spinal injuries and determine its pattern with reference to its neurological outcome. Methodology: Study Design: Prospective cohort study, involving radiographic and clinical review. This study was performed on 69 patients of spinal trauma, January to December, 2018, at Department of Radiology, Gujranwala Medical College and DHQ teaching Hospital, Gujranwala. Male and female of any age were included. After initial neurological examination these patients undergone for Magnetic Resonance Imaging of spine, which were analyzed and correlated with American Spinal Injury Association (ASIA) impairment scale (AIS), then subsequently at sub-acute interval to assess neurological outcome. Data analysis was done on SPSS version 17. Results: The most common MRI findings were spinal cord edema 24 cases (34.7%). Among the other findings were, cord contusion 17 cases (24.6%), spinal cord deformity due to extrinsic compression 14 cases (20.2%), focus of hemorrhage within the cord 9 cases (13%), epidural hematoma 3cases (4.3%) and few cases appeared normal cord 2 cases (2.3%). Most of the MRI findings correlated with clinical presentation of the patient according to American Spinal Injury Association (ASIA) impairment scale. Conclusion: Patients with initial hemorrhagic grade had very poor prognosis, whereas those with focal spinal cord edema had good clinical recovery.