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Titre du document / Document title

Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients. Commentary

Auteur(s) / Author(s)

TEWARI Manof K. (1) ; GIFTI Dipender S. (1) ; SINGH Paramjit (2) ; KHOSLA Virender K. (1) ; MATHURIYA Suresh N. (1) ; GUPTA Sunil K. (1) ; PATHAK Ashis (1) ; MAIMAN Dennis J. (Commentateur) (3) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, INDE
(2) Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, INDE
(3) Spinal Cord Injury Center, Milwaukee, Wisconsin 53226, ETATS-UNIS

Résumé / Abstract

Background: Spinal cord injury without radiographic abnormality (SCIWORA) is not uncommon among middle-aged and elderly people. It is less reported in adults as compared with children. This study was undertaken to find the incidence, magnetic resonance imaging (MRI) changes, and outcome of SCIWORA in adults and to demonstrate the prognostic value of MRI in SCIWORA. Materials and Methods: Forty adult patients who sustained SCIWORA for a period of 2 years (January 1999 to December 2000) were admitted to our hospital. Methylprednisolone was given in therapeutic doses, for a period of 24 hours, to those arriving within 6 hours of injury. Magnetic resonance imaging was performed within 72 hours of admission to the hospital. In all patients, sagittal, axial, and coronal T1, spin, and T2 images of MRI were obtained. Clinical status of the patient at the time of admission and discharge was correlated with MRI. Results: Four patients (10%), who were in Frankel grade D, with no demonstrable injury on MRI, improved to Frankel grade E at the time of discharge. Two patients (5%) with cord edema and extraneural injury improved to a useful neurological grade (Frankel grades D or E), whereas 13 patients (32.5%) with MRI features of cord contusion and hemorrhage did not achieve useful neurological function. Conclusion: Spinal cord injury without radiographic abnormality contributes 12% of cases of spinal cord injury. Magnetic resonance imaging is the investigation of choice, having diagnostic and prognostic value because it demonstrates neural and extraneural injuries and helps to pick up surgically correctable abnormality. Patients with minimal cord changes on MRI have the best outcome followed by those with cord edema. Patients with parenchymatous hemorrhage and contusion on MRI fare badly.

Revue / Journal Title

Surgical neurology    ISSN  0090-3019   CODEN SGNRAI 

Source / Source

2005, vol. 63, no3, pp. 204-209 [6 page(s) (article)] (39 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1973-2009) (Revue)

Mots-clés anglais / English Keywords

Prognosis

;

Human

;

Nuclear magnetic resonance imaging

;

Radiography

;

Spinal cord

;

Trauma

;

Diagnosis

;

Surgery

;

Nervous system diseases

;

Mots-clés français / French Keywords

Pronostic

;

Homme

;

Imagerie RMN

;

Radiographie

;

Moelle épinière

;

Traumatisme

;

Diagnostic

;

Chirurgie

;

Système nerveux pathologie

;

Mots-clés espagnols / Spanish Keywords

Pronóstico

;

Hombre

;

Imaginería RMN

;

Radiografía

;

Médula espinal

;

Traumatismo

;

Diagnóstico

;

Cirugía

;

Sistema nervioso patología

;

Mots-clés d'auteur / Author Keywords

Spinal cord injury (SCI)

;

Spinal cord injury without radiographic abnormality (SCIWORA)

;

Spinal cord injury without radiological evidence of trauma (SCIWORET)

;

Magnetic resonance imaging (MRI)

;

Prognosis

;

Localisation / Location

INIST-CNRS, Cote INIST : 16065, 35400012936895.0020

Nº notice refdoc (ud4) : 16585227



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