Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Simulation-based learning in orthopaedics: A qualitative systematic review","authors":"Mainak Roy ,&nbsp;Priyadarshini T ,&nbsp;M.S. Ashika ,&nbsp;Gurudip Das ,&nbsp;Bishnu Prasad Patro ,&nbsp;Sanjeevi Bharadwaj","doi":"10.1016/j.jcot.2025.102986","DOIUrl":"10.1016/j.jcot.2025.102986","url":null,"abstract":"<div><h3>Introduction</h3><div>Simulation-based learning has emerged as a transformative tool in orthopaedic education, significantly improving surgical training and patient safety. This systematic review examines the role of simulation in enhancing technical skills, decision-making, and clinical competence among orthopaedic trainees.</div></div><div><h3>Methods</h3><div>A systematic review was conducted to assess the effectiveness of simulation-based training in orthopaedics. Various simulation modalities, including virtual reality (VR), augmented reality (AR), haptic feedback systems, and task-based trainers, were analyzed for their impact on skill acquisition and retention. The study was registered with PROSPERO (ID: CRD420250652679).</div></div><div><h3>Results</h3><div>Key findings suggest that simulation-based training leads to reduced surgical errors, faster learning curves, and better skill retention. However, challenges such as high costs, limited access to advanced simulation tools, and difficulties in integrating these technologies into traditional curricula persist.</div></div><div><h3>Conclusion</h3><div>Simulation is expected to play a crucial role in modernizing orthopaedic education by providing safe, repeatable practice opportunities. Future directions include AI-driven training modules and collaborative VR platforms to further enhance training efficacy and patient outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102986"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-operative versus reverse shoulder arthroplasty for the treatment of 3- or 4-part proximal humeral fractures: A systematic review and meta-analysis","authors":"Victor Yan Zhe Lu ,&nbsp;Halia Shah ,&nbsp;Zainab Alshaber ,&nbsp;Aaron Limonard ,&nbsp;Peter Domos","doi":"10.1016/j.jcot.2025.102982","DOIUrl":"10.1016/j.jcot.2025.102982","url":null,"abstract":"<div><h3>Background</h3><div>Proximal humerus fractures (PHFs) are a common injury experienced by elderly patients, however there is no consensus regarding the best treatment option. Recently, the use of reverse shoulder arthroplasty (RSA) in elderly patients with complex fractures is increasing. This systematic review and meta-analysis will compare the outcomes between RSA and non-operative treatment in 3- or 4-part PHFs in the elderly.</div></div><div><h3>Methods</h3><div>This study was conducted according to the PRISMA statement protocol and registered in PROSPERO (CRD42023439647). Searches on four databases (Medline, Embase, Web of Science, and Cochrane Library) were performed, and comparative studies which compared the outcomes of using RSA with conservative management were included. Demographic data, patient related outcome measures (PROMs), and complications rates were collected. Data were pooled using a random-effects model. Heterogeneity was determined using the I² statistic and Cochran's Q test.</div></div><div><h3>Results</h3><div>Six studies involving 439 patients (mean age 79.0 years old; 12.1 % male) were analysed. The average Charlson co-morbidity index (CCI) was 3.74 and follow-up time was 26.0 months. Compared to the non-operative cohort, the RSA cohort had better VAS scores (1.0 versus 0.575; p = 0.047), Constant-Murley scores (66.3 versus 71; p = 0.114), active forward flexion (121.5° versus 100°; p = 0.023; I² = 35 %), external rotation (34.8° vs 23.1°; p = 0.020), and internal rotation (Constant score 5.44 versus 4.28; p = 0.169). There is no difference in the overall risk of complications (8.2 % versus 6.0 %; RR = 1.00; p = 0.993), but those treated by RSA have a higher risk of needing subsequent revision surgery (3.7 % versus 2.8 %; p = 0.640; I² = 25 %).</div></div><div><h3>Conclusion</h3><div>In the short-term, elderly patients with complex PHFs treated with RSA may have decreased pain, increased Constant-Murley scores, and increased ROM compared with patients treated non-operatively, at the expense of a higher risk of needing subsequent surgery. However, moderate between-study heterogeneity in effect sizes and the retrospective nature of included studies may limit the clinical applications of conclusions obtained in this review.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102982"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The biomechanical and functional outcomes of fresh osteochondral allograft for the knee: A systematic review","authors":"Stephanie Picioreanu ,&nbsp;Leela Biant ,&nbsp;Gwenllian Tawy","doi":"10.1016/j.jcot.2025.102983","DOIUrl":"10.1016/j.jcot.2025.102983","url":null,"abstract":"<div><h3>Background</h3><div>Fresh osteochondral allograft (FOCA) is a treatment option for osteochondral lesions of the knee which cause pain, locking, and joint instability. While FOCA aims to eliminate these mechanical symptoms, the biomechanical outcomes of the procedure remain poorly understood. This systematic review aimed to collate and interpret the available literature on the biomechanical outcomes of FOCA.</div></div><div><h3>Methods</h3><div>Systematic searches were performed in three databases using the terms ‘(Knee OR knee joint) AND (FOCA OR fresh osteochondral allograft OR fresh OCA)’. Eligible studies contained objective biomechanical or functional outcomes, such as knee range of motion, strength, or parameters of gait. The National Institute of Health Quality Assessment Tool assessed study quality. Extracted data were synthesised in a spreadsheet and then a linear regression analysis was performed on the available range of motion data (p = 0.05). Data from a prior systematic review on the biomechanical outcomes of autologous chondrocyte implantation (ACI) were also included in this analysis to facilitate interpretation of the results. PROSPERO ID: CRD42024531998.</div></div><div><h3>Results</h3><div>Eight studies with 54 participants met the inclusion criteria. On average, studies included 10 participants with a follow up range of 9–108 months.</div><div>Knee range of motion was reported to improve post-operatively in each study, and the post-operative range of motion was generally reported to be &gt; 120°. A linear regression analysis showed no correlation between final range of motion and follow-up time (p value – 0.860; R² - 0.019). These results did not differ statistically from the range of motion data reported in a prior review on ACI outcomes (F = 0.003; p = 0.874).</div><div>One study also reported an improvement in knee strength following FOCA, while two others commented on improvements to gait, although little numerical data was provided.</div></div><div><h3>Conclusion</h3><div>The limited reporting of improvements to knee range of motion suggest that FOCA has the potential to improve patient quality of life through improved knee function. Linear regression analyses of data presented in this study and obtained from a prior report on the biomechanical outcomes of ACI suggest that the knee ranges of motion following both procedures are comparable. However, further research with larger patient cohorts and consistent methodologies are required to corroborate existing data. This knowledge is important for optimising outcomes via evidence-based rehabilitation programmes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102983"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Current trends in shoulder arthroplasty - Are the trends backed by evidence? [Journal of Clinical Orthopaedics and Trauma 62 (2025) 102897]","authors":"David W. Shields ,&nbsp;Yash Sewpaul ,&nbsp;Sandeep K. Nayar ,&nbsp;Caroline M. Atherton ,&nbsp;Joaquim Goffin ,&nbsp;Mustafa S. Rashid","doi":"10.1016/j.jcot.2025.102981","DOIUrl":"10.1016/j.jcot.2025.102981","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 102981"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder arthroplasty in the elderly","authors":"P. Raval ,&nbsp;Harvinder Singh","doi":"10.1016/j.jcot.2025.102976","DOIUrl":"10.1016/j.jcot.2025.102976","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder arthroplasty is increasingly being used for definitive treatment of various shoulder pathologies, especially in more elderly patients. Controversy surrounds the optimal choice in total shoulder arthroplasty for elderly patients. In this review we discuss the options available when considering TSA for an elderly patient.</div></div><div><h3>Review</h3><div>Anatomical total shoulder arthroplasty (ATSA) relies upon an intact, functioning rotator cuff. Reverse total shoulder arthroplasty (RTSA) relies upon a functioning deltoid for optimal outcomes. The setting of partial cuff tears. Both options confer their own advantages and disadvantages.</div><div>ATSA are a valuable treatment option for elderly patients with severe shoulder arthritis or degenerative conditions, offering significant pain relief and functional improvement. While it provides numerous advantages, including pain relief, preservation of bone stock, and natural joint mechanics, careful patient selection and consideration of potential drawbacks such as rotator cuff integrity and surgical complexity are crucial for optimising outcomes in this population.</div><div>RTSA has become a valuable treatment solution for elderly patients with complex shoulder conditions, offering significant pain relief, improved functionality, and enhanced quality of life. While careful consideration of patient factors and potential complications is necessary, RTSA continues to demonstrate favourable outcomes and good survivorship in the elderly.</div></div><div><h3>Discussion</h3><div>Debate continues optimal shoulder arthroplasty management for elderly patients. Technology continues to advance the surgical technique for shoulder arthroplasty and address some of the challenges encountered. Research continues to try and help answer many of the debated areas of shoulder arthroplasty, but current evidence continues to show an improving trend in survivorship and long-term outcomes for most shoulder arthroplasty procedures.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102976"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring the approach: Management of femur fractures in post-polio syndrome patients","authors":"Venkatesan Senthil Kannan,&nbsp;Singanallur Palanivelayutham Sivakumar,&nbsp;Jayaramaraju Dheenadhayalan,&nbsp;Shanmuganathan Rajasekaran","doi":"10.1016/j.jcot.2025.102979","DOIUrl":"10.1016/j.jcot.2025.102979","url":null,"abstract":"<div><h3>Background</h3><div>Post-polio syndrome (PPS) can significantly alter lower limb anatomy and function. Femur is the most commonly fractured bone in post-polio patients. This study aimed to investigate the surgical challenges, fixation techniques employed, and functional outcomes in PPS patients with femoral fractures.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 38 PPS patients diagnosed with femoral fractures. We assessed the underlying injury mechanism, anatomical variations (e.g., valgus neck deformity, hypoplastic greater trochanter, narrow canal, fixed knee flexion), and employed fixation techniques. Union time and functional recovery were evaluated.</div></div><div><h3>Results</h3><div>Trivial falls were the most frequent cause of fracture. Notably, various anatomical variations were observed, potentially influencing treatment strategies. Intramedullary nailing was the preferred fixation method; however, some cases necessitated alternative extramedullary fixation techniques due to anatomical constraints. The average time for fracture union was 24 weeks, with all patients regaining their pre-fracture functional status.</div></div><div><h3>Conclusion</h3><div>Femoral fracture management in PPS patients requires meticulous consideration of unique anatomical challenges and patient-specific factors. A multidisciplinary approach emphasizing preoperative planning, intraoperative adaptability in fixation techniques, and comprehensive postoperative rehabilitation is crucial for optimal outcomes and minimizing complications.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102979"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tranexamic acid on blood loss during THR in patients with inflammatory versus degenerative hip arthritis: A retrospective cohort study","authors":"Mohabey Ankush,&nbsp;Sah Saurabh,&nbsp;Dwidmuthe Samir,&nbsp;Kotangale Pratik,&nbsp;Sahare Pratik","doi":"10.1016/j.jcot.2025.102977","DOIUrl":"10.1016/j.jcot.2025.102977","url":null,"abstract":"<div><h3>Background</h3><div>Tranexamic acid (TXA) is increasingly used to minimize blood loss associated with total hip replacement (THR), yet its comparative efficacy in inflammatory versus degenerative arthritis during THR remains underexplored in Indian patients. The objective of this study was to evaluate and compare the estimated intraoperative blood loss in patients undergoing THR with and without TXA administration, stratified by underlying degenerative and inflammatory joint conditions.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed medical records of patients undergoing THR at a single center from October 2020 to October 2023. Patients were stratified by TXA usage and the type of arthritis (inflammatory and degenerative). The primary outcome was intraoperative blood loss, while secondary outcomes included operative time and time to full weight-bearing.</div></div><div><h3>Results</h3><div>The study enrolled 126 patients, including 21 with inflammatory arthritis and 105 with degenerative arthritis, of whom 106 received TXA (n = 19, inflammatory arthritis; n = 87, degenerative arthritis).</div><div>The primary outcome of mean intraoperative blood loss was lower in the TXA group (350.57 ± 162.36 mL) compared to the non-TXA group (380.00 ± 192.22 mL), although this difference did not reach statistical significance (p = 0.472).</div><div>Secondary outcome, operative time was significantly shorter in patients receiving TXA (88.53 ± 24.38 min) compared to those who did not receive TXA (102.58 ± 45.27 min, p = 0.046). While the time to full weight-bearing was comparable between the TXA users and non-users (p = 0.341).</div><div>Subgroup analysis suggested a more pronounced reduction in blood loss with TXA use among patients with degenerative arthritis than those with inflammatory arthritis, though the difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div>TXA administration in THR significantly reduced operative time but showed no significant difference in blood loss or postoperative recovery. The results suggest a potential for more pronounced benefits in patients with degenerative arthritis.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102977"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 3D CT morphometric analysis of the medial pelvic terrain: New insights into quadrilateral plate and medial acetabular surface","authors":"Abhay Elhence,&nbsp;Ashraf Jamal,&nbsp;Sandeep Kumar Yadav","doi":"10.1016/j.jcot.2025.102978","DOIUrl":"10.1016/j.jcot.2025.102978","url":null,"abstract":"<div><h3>Background</h3><div>The medial bony hemipelvis has been defined as quadrilateral plate (QP). Any isolated or combined injuries to QP, often lead to early degenerative arthritis of hip joint. Conventionally defined QP and its delineation of fixation zones from non-fixation zone or medial acetabular surface (MAS) will lead to novel Pentagonal Plate (PP).</div></div><div><h3>Methodology</h3><div>3D reconstructions of the pelvic CT scans were created, focusing on right hemipelvis for all patients. The dimensions of the QP and novel PP in the right hemipelvis were defined and measured using RadiAnt DICOM Viewer software. Statistical analysis was conducted using latest version of SPSS software.</div></div><div><h3>Results</h3><div>This study included 100 adults (42 females and 58 males) who underwent CT scans of pelvis for non traumatic non orthopedic reasons like gynaecological, general surgical and urological reasons between July 2019 and December 2020. Average dimensions of the sides of conventional QP were found to be 4.95 ± 0.85 cm, 3.98 ± 0.73 cm, 4.03 ± 0.78 cm, and 5.48 ± 0.91 cm. The study identifies 3 triangular fixation zones within conventional QP, corresponding to the sciatic buttress, part of anterior column, and part of the posterior column. These zones were excluded from conventional QP, resulting in definition of a novel pentagonal plate (PP) with a 34 % smaller surface area, precisely delineating true medial surface of acetabular socket.</div></div><div><h3>Conclusion</h3><div>Novel PP identifies MAS with more precision and delineates 3 triangular fixation zones across sciatic buttress, anterior and posterior columns. This knowledge enables better understanding of fixation zones and force concentration due to antecedent injury which opens doors to newer plate designs, explaining why certain fractures involving the MAS undergo early degenerative arthritis and rationalizing alternative treatment strategies like fix and replace for even younger patients with adverse fracture configurations.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102978"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative and newer drug treatment for degenerative cervical myelopathy","authors":"Osita Ede ,&nbsp;Jason Pui Yin Cheung","doi":"10.1016/j.jcot.2025.102972","DOIUrl":"10.1016/j.jcot.2025.102972","url":null,"abstract":"<div><div>Degenerative cervical myelopathy (DCM) is the most common cause of non-traumatic spinal cord dysfunction in adults worldwide. Conservative treatments, such as physical therapy, activity modification, cervical traction, and the use of cervical collars, have been employed primarily for symptomatic relief in mild cases or for patients deemed unfit for surgery. Advances in our understanding of the molecular pathways involved in neuroinflammation and neuronal injury in DCM have spurred the development of newer pharmacological treatments aimed at neuroprotection and inflammation control. We found limited evidence that conservative treatment enhances functional recovery in patients with DCM. Patients with mild DCM who opt for conservative therapy should be aware of likely neurological deterioration and higher spinal cord injury risk following neck trauma. Nonoperative management could benefit patients with mild DCM who presented early (at least less than a year), have soft disc herniation as the cause of the myelopathy, have one level of myelopathic compression, and whose MRI does not show circumferential compression of the spinal cord. Riluzole did not replicate its promising animal results in human trials, using the modified Japanese Orthopaedic Association (mJOA) score as an outcome measure. Cerebrolysin is promising but needs more RCTs to define its role in the management algorithm. Limaprost Alfadex provided inconclusive evidence, however, is in an ongoing phase III trial. Erythropoietin showed benefit in animal and human trials but concerns over side effects may limit use. G-CSF demonstrated evidence of preserved neurological function in mice but needs human studies. Steroids did not show benefit and are likely deleterious to tissue healing and can increase infection risk. Anti-Fas ligand antibody has not been studied in humans but demonstrated benefit in animal models. Research should focus on large-scale RCTs for these drugs with careful attention to long-term effects, side effects, and finding the most effective doses.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102972"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between MRI and DTI parameters in acute thoracic spinal cord injury and clinical outcomes: A prospective observational study","authors":"Vishal Verma ,&nbsp;Anil Regmi ,&nbsp;Aakash Jain ,&nbsp;Siddharth Shekhar Sethy ,&nbsp;Pankaj Kandwal ,&nbsp;Bhaskar Sarkar","doi":"10.1016/j.jcot.2025.102975","DOIUrl":"10.1016/j.jcot.2025.102975","url":null,"abstract":"<div><h3>Study design</h3><div>Prospective Observational Study.</div></div><div><h3>Objective</h3><div>The current study aims to explore the correlation of MRI and DTI parameters in acute thoracic spinal cord injuries for prediction of neurological outcomes.</div></div><div><h3>Setting</h3><div>University level tertiary care hospital of Northern India.</div></div><div><h3>Methods</h3><div>Conventional MRI and DTIs were performed for 51 acute thoracic spinal cord injury patients. The relationship of MRI and DTI parameters with preoperative and postoperative AIS motor and sensory scores in complete and incomplete neurological deficit groups were done. AIS score, AO PROST Score and ODI score was used for neurological and functional assessment of spinal cord functions. Patients were divided into group I (ASIA A) and Group II (ASIA B, C, D). MRI and DTI parameters were compared between groups for their predictive value on neurology at admission and at final follow up.</div></div><div><h3>Results</h3><div>Out of 20 patients in group I, 3 patients recovered by grade 1 and 6 patients by grade 2 and no recovery in 11 patients. In group II out of 31 patients 10 patients (33.4 %) recovered to ASIA E neurology. On Univariate analysis MOCC, SCC, Length of Cord swelling, LOE, Distortion index, Type of injury and Hematomyelia were significantly associated with complete neurological deficit at presentation. However, on final follow up, MOCC, SCC, Length of cord edema, and Hematomyelia were significant in predicting neurology.</div></div><div><h3>Conclusion</h3><div>Maximum osseous canal compromise, Spinal Cord Compression, Length of Edema, Length of Spinal cord swelling, and hematomyelia are best correlated with prediction of a neurological deficit. DTI also provides superior spinal cord imaging but faces technical challenges.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 102975"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}