Evaluation of spinal injuries by MRI

Abstract

Background:Radio-imaging is one of the most important tools in the diagnosis of spinal injury and helps to start a prompt and correct treatment to patients. Compared to CT, MRI allows better visualization of various tissues, including spinal cord and ligaments, not to mention discs and vessels. This study was done to evaluate the efficacy of low tesla MRI in acute spinal injuries. Methods: Site of injury, neurological status of the patient etc., were noted from 78 patients included in the study. The neurological status was evaluated according to the American Spinal Injury Association Impairment Scale. Within 2days of admission, MRI was done. In case of doubt, radiographs for superior and articular processes was done where necessary. CT was done in case edema was seen without a fracture line. Results: Most of the patients were males with the maximum of the patients being between the ages 21-50 years. Fall from height was the most common cause of injury and cervical region was the most common site. Osseous injury, ligament disruption and spinal cord injury were the most common MRI findings. Conclusions: Being non-invasive procedure with high specificity and sensitivity, MRI is a preferred diagnostic tool to assess the spinal cord injuries.

Role of MRI in the evaluation of spinal trauma

“…In a similar study, Kulkarni et al [23] revealed the presence of cord abnormalities in 70% of patients 1 .Preethi Ganesan et al [16] [16] in their study showed that 8 subjects were graded as AIS E (12.3%), on follow up 15 subjects graded as AIS E. Hence these findings were similar to our study. Severity of injury according to ASIA in Bollipo JP et al [8] study was grade D (39.7%), grade A (35.9%), grade C (15.4%) and grade B (9%). In a study by Bozzo A et al [18] , 40% of the patients had grade A severity, 22% had grade B, 33% had grade C, 34% had grade D and 11% had normal cord i.e., Grade E. A study by Andreoli C et al [19] , reported 42% ASIA Grade A, 32% Grade B, 42% grade C and 26% grade D. However, a study by Shimada K et al reported a higher-Grade C (40%) compared to the other severity grades [20] .…”

“…Minimum subjects were from the age group of 51-60 years (6%) followed by 11-20 years (10%). The relative predominance of young male patients is most likely due to increased mobility, work related injuries and road traffic accidents.Bollipo JP et al [8] in their study mentioned that most of the patients were males with the maximum of the patients being between the ages 21-50 years.Gender related findings correlate well with the similar studies done by, Hassan Gamal G [9] , Gupta R et al [10] , Debebe F et al [11] and Lalwani S et al [12] . Age group of affected patients were comparable with the findings of Gupta R et al [10] and Hassan Gamal G [9] .…”

“…Similar results were also obtained in the studies conducted by Debebe F. et al 11 ,Rahimi-Movaghar V. et al [14] and Tee J. et al [15] . Gurinder Bir Singh et al [13] in their study revealed that the most common cause of spine related injury in 29(58%) cases, followed by fall from height in 12(24%) cases and assault in 5(10%) cases.Bollipo JP et al [8] in their study showed that the most common cause of injury was fall from ~ 25 ~ height where 39 (50%) of the patients were affected, followed by 23 patients who had road traffic accident (28.5%).…”

“…According to Bollipo JP et al [8] , of the osseous fracture injuries, vertebral fracture was observed in 37 (47.4%) of the patients, posterior elements fracture was observed in 5 (6.4%) patients and dislocation was observed in 21 (26.9%) of the patients.According to Gurinder Bir Singh et al [13] , vertebral body injury was seen in 20 (40%) cases while posterior element was found in 4% of the subjects.…”