Diagnostic yield of magnetic resonance (MRI) imaging and treatment outcomes in patients with spinal cord trauma in, Nigeria: A single centre study

Abstract

Background: Spinal cord trauma (SCT) is a devastating condition that can lead to significant neurological impairment and reduced quality of life. Magnetic Resonance Imaging (MRI) has been playing an increasingly important role in the management of spinal trauma patients. This study was designed to determine diagnostic yield of magnetic resonance imaging and the relationship between MRI findings and treatment outcomes in patients with trauma to the spinal cord. Materials and Method: A total of 245 patients who meet the inclusion criteria had their records and MRI findings evaluated retrospectively using convenience sampling method. The quantitative parameters that were used included: maximum spinal cord compression (MSCC), maximum canal compromise (MCC) and length of lesion while the qualitative parameters used are; intramedullary haemorrhage, cord oedema, cord swelling, disc herniation and soft tissue injury. Data such as cause of injury, anatomical level of injury, associated injury, and time of presentation, neurological/clinical presentation, and patterns of treatment, duration of hospitalization, ASIA classification and treatment outcome were collected. Results: The majority 53.47% (n = 131) had cervical spine involvement. Greater proportion 61.22 % (n=150) of spinal cord injuries were caused by road traffic accident (RTA). Most of the patients 33.06% (n=81) had only haemorrhage. Majority 51.02% (n = 125) had ASIA A and the least 4.49% (n = 11) had ASIA E classification. Among ASIA A patients, 21.63% (n = 53) had only haemorrhage while 29.39% (n= 72) had both haemorrhage and Oedema. Out of 53 ASIA A patients that had only haemorrhage, 21.57% (n = 11) of the ASIA A patients had incomplete recovery while 78.43% (n = 42) had no recovery. Out of the 72 ASIA A patients that had both haemorrhage and oedema, 18.06% (n = 13) had incomplete recovery while 81.94% (n = 59) had no recovery. Conclusion: The majority of the patients had cervical spine cord injuries and RTA was the most common causes of spinal cord injuries. Most of the patients had ASIA a classes of spinal cord injuries with more of them having only haemorrhage. The patients’ recovery rate was very poor across all the various classes of ASIA and MRI has shown to be good prognostic tools for the evaluation of spinal cord injuries.