Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry

Spinal Cord, 2017 · DOI: 10.1038/sc.2017.18 · Published: July 1, 2017

Spinal Cord Injury Physiology Medical Imaging

Simple Explanation

This study investigates the relationship between spinal cord damage, as seen on MRI, and walking ability in people with incomplete spinal cord injuries. The study looks at how the size of the damaged area on MRI relates to walking ability, motor function, and changes in leg muscles. Researchers used a special type of MRI to measure the amount of swelling (edema) in the spinal cord. They then compared these measurements to how well participants could walk, the strength of their leg muscles, and the amount of fat in their leg muscles. The study found that more damage in the spinal cord was linked to poorer walking ability and weaker leg muscles. This suggests that MRI scans could help predict how well someone will recover their walking ability after a spinal cord injury.

Study Duration

Not specified

Participants

14 participants with iSCI (1 female and 13 males)

Evidence Level

Cross-sectional study

Key Findings

1
Damage ratios were negatively correlated with distance walked in 6 minutes, average daily strides, and maximum plantarflexion torque.
2
Damage ratios were also negatively correlated with the Walking Index for Spinal Cord Injury II scores.
3
The wheelchair user participant group had significantly elevated lower extremity MFI compared to the community walker group.

Research Summary

This study demonstrated a negative correlation between damaged cord ratios and both walking ability and plantarflexion torque output in participants with iSCI. These findings suggest that axial spinal cord damage ratios on high resolution T2-weighted MRI may be useful in predicting recovery of walking ability early after spinal cord injury. In this study, we demonstrated that measurement of spinal cord edema using high-resolution axial T2-weighted imaging is possible and that damage ratios were negatively correlated with ambulatory status as well as plantarflexion torque generation in 14 participants with iSCI.

Practical Implications

Prognostic Value

Axial spinal cord damage ratios on high resolution T2-weighted MRI may be useful in predicting recovery of walking ability early after spinal cord injury.

Clinical Prediction Rule

Quantitative damage ratio metric may be valuable for a clinical prediction rule of future walking ability.

Therapeutic Intervention

The correlation between physical activity levels and muscle fat infiltration suggests that targeted interventions could improve muscle health.

Study Limitations

1
Inability to provide a cause-and-effect relationship between the amount of spinal cord damage and ambulatory ability.
2
Optimal time-course for axial T2 imaging of spinal cord edema needs to be established.
3
Data measured in the chronic state warrants longitudinal investigation.

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