title: Subacute T1-low intensity area reflects neurological prognosis for patients with cervical spinal cord injury without major bone injury.
abstract: METHODS
  A retrospective imaging and clinical study.
  
  
  OBJECTIVE
  To evaluate the relationship between magnetic resonance imaging (MRI) features and neurological prognosis in patients with traumatic cervical spinal cord injury (CSCI) without major bone injury.
  
  
  METHODS
  A total of 72 patients with CSCI without major bone injury were treated conservatively in our hospital. MRI was performed for all patients at admission and 1 month following injury. We measured the antero-posterior and cranio-caudal diameter of intramedullary intensity changed area with T1-weighted images at the injured segment. Neurological evaluations were performed using the American Spinal Injury Association (ASIA) motor score and the modified Frankel grade at the time of admission and discharge.
  
  
  RESULTS
  There was a significant relationship between the antero-posterior diameter ratio of the T1-weighted low-intensity area on MRI at the subacute stage and the ASIA motor score. The optimal threshold of the T1-weighted low-intensity diameter ratio for predicting the patient's ability to walk with or without assistance at discharge was determined to be 46%. Moreover, 96.8% of the patients with <50% T1-weighted low-intensity area recovered to walk with or without a cane at discharge.
  
  
  CONCLUSIONS
  The T1-low intensity area may be an important predictive factor for the neurological recovery of CSCI without major bone injury.
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Matsushita
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Mori
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Yugue
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Kawano
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ueta
authors.affiliation: Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shiba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066193:Cervical Cord; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000473:pathology* / Q000503:physiopathology*