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Spinal cord swelling and intradural compression predict neurological recovery after acute cervical traumatic spinal cord injury

Author

Listed:
  • Harshit Arora
  • Hassan Darabi
  • Nathaniel Toop
  • Amy Minnema
  • Zahraa Al-Sharshahi
  • Grace M Martin
  • Kelsey Karnik
  • Jan M Schwab
  • Francis Farhadi

Abstract

Intradural spinal cord compression impairs perfusion pressure and is putatively rate-limiting for recovery after traumatic spinal cord injury (tSCI). After cervical tSCI, even minimally improved tissue preservation may help promote neurological recovery. To assess the nature and extent of spinal cord swelling and compression post-acute cervical tSCI, we evaluated several baseline MRI parameters including BASIC score, intramedullary lesion (IML) length, maximal canal compromise (MCC), maximal spinal cord compression (MSCC), extent of cord compression (ECC), maximal swollen anteroposterior diameter adjacent to injury site (Dmax), and maximal cord swelling (MCS) in 169 consecutive patients across 2 centers. In patients with either primarily intradural or combined (MSCC ≤5% or >5%, respectively) cord compression, we examined the predictive value of clinical and imaging admission parameters on American Spinal Injury Association Impairment Scale (AIS) severity and conversion up to 1-year follow-up. 37 (21.9%) patients presented with primarily intradural while 132 (78.1%) had combined cord compression. MSCC, MCS, and Dmax values differed significantly between the two groups (p

Suggested Citation

  • Harshit Arora & Hassan Darabi & Nathaniel Toop & Amy Minnema & Zahraa Al-Sharshahi & Grace M Martin & Kelsey Karnik & Jan M Schwab & Francis Farhadi, 2025. "Spinal cord swelling and intradural compression predict neurological recovery after acute cervical traumatic spinal cord injury," PLOS ONE, Public Library of Science, vol. 20(8), pages 1-14, August.
    • Handle: RePEc:plo:pone00:0325827
    DOI: 10.1371/journal.pone.0325827
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