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New Grading System for Cervical Paraspinal Soft Tissue Damage After Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological Improvements: The STIR-MRI Grade
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To develop a grading method for cervical paraspinal soft tissue damage after cervical spinal cord injury (CSCI) without major fracture based on the short T1 inversion recovery (STIR) mid-sagittal magnetic resonance image (MRI) for prediction of ne...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189345/ https://www.ncbi.nlm.nih.gov/pubmed/33878911 http://dx.doi.org/10.1177/21925682211010122 |
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author | Aburakawa, Kotaro Yokoyama, Toru Takeuchi, Kazunari Numasawa, Takuya Wada, Kanichiro Kumagai, Gentaro Tanaka, Sunao Asari, Toru Otsuka, Hironori Ishibashi, Yasuyuki |
author_facet | Aburakawa, Kotaro Yokoyama, Toru Takeuchi, Kazunari Numasawa, Takuya Wada, Kanichiro Kumagai, Gentaro Tanaka, Sunao Asari, Toru Otsuka, Hironori Ishibashi, Yasuyuki |
author_sort | Aburakawa, Kotaro |
collection | PubMed |
description | STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To develop a grading method for cervical paraspinal soft tissue damage after cervical spinal cord injury (CSCI) without major fracture based on the short T1 inversion recovery (STIR) mid-sagittal magnetic resonance image (MRI) for prediction of neurological improvements. METHODS: This study included 34 patients with CSCI without major fracture, treated conservatively for at least 1 year and graded using the STIR-MRI Grade. This system consists of anterior grades; A0: no high-intensity area (HIA), A1: linear HIA, and A2: fusiform HIA, and posterior grades; P0: no HIA, P1: HIA not exceeding the nuchal ligament, and P2: HIA exceeding the nuchal ligament, within 24 hours postinjury. The American Spinal Injury Association impairment scale (AIS) and the Japanese Orthopedic Association (JOA) scores were examined. RESULTS: Anterior grades were not significantly correlated with the AIS and JOA score. At both injury and final follow-up, the AIS in P2 patients was significantly more severe (P = 0.007, P = 0.015, respectively) than that in P0 patients. At the injury, the AIS in P2 patients was significantly more severe (P = 0.008) than that in P1 patients. Among P2 patients only, the JOA score at the injury (1.4 points) did not improve by the final follow-up (3.9 points). The final follow-up JOA score (3.9 points) in P2 patients was significantly lower than that (13.6 points) in P0 patients (P = 0.016). CONCLUSIONS: Grade P2 led to poor neurological outcomes. The STIR-MRI Grade is a prognostic indicator for neurological improvements past-CSCI. |
format | Online Article Text |
id | pubmed-10189345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-101893452023-05-18 New Grading System for Cervical Paraspinal Soft Tissue Damage After Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological Improvements: The STIR-MRI Grade Aburakawa, Kotaro Yokoyama, Toru Takeuchi, Kazunari Numasawa, Takuya Wada, Kanichiro Kumagai, Gentaro Tanaka, Sunao Asari, Toru Otsuka, Hironori Ishibashi, Yasuyuki Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To develop a grading method for cervical paraspinal soft tissue damage after cervical spinal cord injury (CSCI) without major fracture based on the short T1 inversion recovery (STIR) mid-sagittal magnetic resonance image (MRI) for prediction of neurological improvements. METHODS: This study included 34 patients with CSCI without major fracture, treated conservatively for at least 1 year and graded using the STIR-MRI Grade. This system consists of anterior grades; A0: no high-intensity area (HIA), A1: linear HIA, and A2: fusiform HIA, and posterior grades; P0: no HIA, P1: HIA not exceeding the nuchal ligament, and P2: HIA exceeding the nuchal ligament, within 24 hours postinjury. The American Spinal Injury Association impairment scale (AIS) and the Japanese Orthopedic Association (JOA) scores were examined. RESULTS: Anterior grades were not significantly correlated with the AIS and JOA score. At both injury and final follow-up, the AIS in P2 patients was significantly more severe (P = 0.007, P = 0.015, respectively) than that in P0 patients. At the injury, the AIS in P2 patients was significantly more severe (P = 0.008) than that in P1 patients. Among P2 patients only, the JOA score at the injury (1.4 points) did not improve by the final follow-up (3.9 points). The final follow-up JOA score (3.9 points) in P2 patients was significantly lower than that (13.6 points) in P0 patients (P = 0.016). CONCLUSIONS: Grade P2 led to poor neurological outcomes. The STIR-MRI Grade is a prognostic indicator for neurological improvements past-CSCI. SAGE Publications 2021-04-21 2023-05 /pmc/articles/PMC10189345/ /pubmed/33878911 http://dx.doi.org/10.1177/21925682211010122 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Aburakawa, Kotaro Yokoyama, Toru Takeuchi, Kazunari Numasawa, Takuya Wada, Kanichiro Kumagai, Gentaro Tanaka, Sunao Asari, Toru Otsuka, Hironori Ishibashi, Yasuyuki New Grading System for Cervical Paraspinal Soft Tissue Damage After Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological Improvements: The STIR-MRI Grade |
title | New Grading System for Cervical Paraspinal Soft Tissue Damage After
Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the
Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological
Improvements: The STIR-MRI Grade |
title_full | New Grading System for Cervical Paraspinal Soft Tissue Damage After
Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the
Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological
Improvements: The STIR-MRI Grade |
title_fullStr | New Grading System for Cervical Paraspinal Soft Tissue Damage After
Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the
Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological
Improvements: The STIR-MRI Grade |
title_full_unstemmed | New Grading System for Cervical Paraspinal Soft Tissue Damage After
Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the
Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological
Improvements: The STIR-MRI Grade |
title_short | New Grading System for Cervical Paraspinal Soft Tissue Damage After
Traumatic Cervical Spinal Cord Injury Without Major Fracture Based on the
Short-T1 Inversion Recovery Mid-Sagittal MRI for Prediction of Neurological
Improvements: The STIR-MRI Grade |
title_sort | new grading system for cervical paraspinal soft tissue damage after
traumatic cervical spinal cord injury without major fracture based on the
short-t1 inversion recovery mid-sagittal mri for prediction of neurological
improvements: the stir-mri grade |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189345/ https://www.ncbi.nlm.nih.gov/pubmed/33878911 http://dx.doi.org/10.1177/21925682211010122 |
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