ArticleJournal of neurological surgery. Part A, Central European neurosurgery2023
Predicting the Role of Preoperative Intramedullary Lesion Length and Early Decompressive Surgery in ASIA Impairment Scale Grade Improvement Following Subaxial Traumatic Cervical Spinal Cord Injury.
Article in Journal of neurological surgery. Part A, Central European neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 13 citations in OpenAlex.
- Successful management of severe pediatric cervical trauma emphasizing the role of surgical stabilization and intensive rehabilitation in achieving complete recovery: a case report.Journal of medical case reports · 2026Article
- Severity Prediction of Traumatic Cervical Spinal Cord Injury With an AI Model Based on MRI Radiomics.JOR spine · 2026Article
- Ankylosing spondylitis complicated by cervical spine fracture and cervicothoracic epidural hematoma: A case report.Medicine · 2025Article
- Research on multi-algorithm and explainable AI techniques for predictive modeling of acute spinal cord injury using multimodal data.Scientific reports · 2025Article
- Overview of Cervical Spine Injuries Caused by Diving Into Shallow Water on Jeju Island: A 9-Year Retrospective Study in a Regional Trauma Center.Korean journal of neurotrauma · 2025Article
- Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury.Brain & spine · 2025Article
- Application of a novel nested ensemble algorithm in predicting motor function recovery in patients with traumatic cervical spinal cord injury.Scientific reports · 2024Article
- Peak Slope Ratio of the Recruitment Curves Compared to Muscle Evoked Potentials to Optimize Standing Configurations with Percutaneous Epidural Stimulation after Spinal Cord Injury.Journal of clinical medicine · 2024Article
- Prognostic MRI parameters in acute traumatic cervical spinal cord injury.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
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Abstract
backgroundTraumatic cervical spinal cord injury (TCSCI) is a disabling condition with uncertain neurologic recovery. Clinical and preclinical studies have suggested early surgical decompression and other measures of neuroprotection improve neurologic outcome. We investigated the role of intramedullary lesion length (IMLL) on preoperative magnetic resonance imaging (MRI) and the effect of early cervical decompressive surgery on ASIA impairment scale (AIS) grade improvement following TCSCI.
methodsIn this retrospective study, we investigated 34 TCSCI patients who were admitted over a 12-year period, from January 1, 2008 to January 31, 2020. We studied the patient demographics, mode of injury, IMLL and timing of surgical decompression. The IMLL is defined as the total length of edema and contusion/hemorrhage within the cord. Short tau inversion recovery (STIR) sequences or T2-weighted MR imaging with fat saturation increases the clarity of edema and depicts abnormalities in the spinal cord. All patients included had confirmed adequate spinal cord decompression with cervical fixation and a follow-up of at least 6 months.
resultsOf the 34 patients, 16 patients were operated on within 24 hours (early surgery group) and 18 patients were operated on more than 24 hours after trauma (delayed surgery group). In the early surgery group, 13 (81.3%) patients had improvement of at least one AIS grade, whereas in the delayed surgery group, AIS grade improvement was seen in only in 8 (44.5%) patients (early vs. late surgery; odds ratio [OR] = 1.828; 95% confidence interval [CI]: 1.036-3.225). In multivariate regression analysis coefficients, the timing of surgery and intramedullary edema length on MRI were the most significant factors in improving the AIS grade following cervical SCI. Timing of surgery as a unique variance predicted AIS grade improvement significantly (
conclusionSurgical decompression within 24 hours of trauma and shorter preoperative IMLL are significantly associated with improved neurologic outcome, reflected by better AIS grade improvement at 6 months' follow-up. The IMLL on preoperative MRI can reliably predict outcome after 6 months. The present study suggests that patients have lesser chances of AIS grade improvement when the IMLL is ≥61 mm.
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