Spinal cord atrophy after spinal cord injury – A systematic review and meta-analysis

After a spinal cord injury, the spinal cord undergoes atrophy, particularly in the cervical region. This atrophy, measured by the cross-sectional area (cSC CSA), varies across different studies and is influenced by the level of injury. MRI is commonly used to assess spinal cord atrophy by measuring the cross-sectional area. Smaller cSC CSA values are often associated with poorer motor and sensory function, reduced functional independence, and neuropathic pain in individuals with paraplegia. This study aimed to determine the magnitude, effect size, and consistency of spinal cord atrophy following SCI across different studies. It also examined the effect of the level and time since injury on the cSC CSA and described the associations between cSC CSA and functional outcomes.

• 1
  The meta-analysis revealed a significant reduction in cSC CSA in individuals with SCI compared to controls, with a standardized mean difference of -1.48, indicating substantial atrophy.
• 2
  The rate of spinal cord atrophy decreases over time post-injury, best described by a logarithmic model, where the most rapid atrophy occurs shortly after the injury.
• 3
  The meta-correlation analysis indicated that more severe atrophy is associated with more rostral (higher) spinal cord injuries, suggesting that the level of injury significantly influences the extent of atrophy.