The relationship between the functional abilities of patients with cervical spinal cord injury and the severity of damage revealed by MR imaging

BACKGROUND AND PURPOSE: The appearance of the damaged spinal cord after inj ury correlates with initial neurologic deficit, as determined by the Americ an Spinal Injury Association grade and manual muscle test score, as well as with recovery, as assessed by manual muscle test scores. The purpose of th is study was to determine whether the presence of spinal cord hemorrhage an d the size and location of spinal cord edema on il-IR images is predictive of functional recovery in survivors of cervical spinal cord injury (SCI), METHODS: The degree of damage to the cervical spinal cord was measured on t he MR images of 49 patients who underwent imaging within 72 hours of sustai ning SCI, The effects of hemorrhage and length/location of edema on changes in the value of the motor scale of the functional independence measure (FI M) were assessed on admission to and discharge from rehabilitation. RESULTS: Patients without spinal cord hemorrhage had significant improvemen t in self-care and mobility scores compared with patients with hemorrhage. There was no significant effect of spinal cord hemorrhage on changes in loc omotion and sphincter control scores, The rostral limit of edema positively correlated with admission and discharge self-care scores and with admissio n mobility and locomotion scores. Edema length had a negative correlation w ith all FIM scales at admission and discharge. CONCLUSION: The imaging characteristics of cervical SCI (hemorrhage and ede ma) are related to levels of physical recovery as determined by the FIM sca le. Imaging factors that correlate with poor functional recovery are hemorr hage, long segments of edema, and high cervical locations.