Abstract
Study designRetrospective analysis.SettingChina Rehabilitation Research Center, Beijing, China.ObjectiveA retrospective study that documents the modalities and clarifies the heterogeneity among spinal cord injuries (SCIs) caused by trauma to the thoracolumbar vertebral junction.MethodsX-ray and MRI imaging, neurological records, and the urodynamics results of 190 patients were reviewed and used to categorize different SCI modalities. First, injuries were divided into complete and incomplete injuries using the International Standard for Neurological Classification of Spinal Cord Injury. Next, the complete injuries were further grouped using the neurological level of injury and Long T2 signal from mid-sagittal MRI images, whereas the bulboconvernosus reflexes were also used as a reference to detect injury to the sacral cord.ResultsThe SCI modalities were classified into five categories: pure complete epiconus lesion with caudal cord intact (G1), complete epiconus injury with conus medullaris (CM) totally involved in the lesion (G2), CM syndrome, cauda equine syndrome without sacral sparing (G3 and G4), and incomplete injury (G5).ConclusionsThe heterogeneity of SCIs at the thoracolumbar junction was documented, a criterion we propose to be of great significance when selecting patients for clinical trials. In particular, the G2 group, which comprises nearly one third of the patients with epiconus lesions, is sometimes mistaken as G1, an observation that has thus far received insufficient attention.
Highlights
Most spinal trauma occurs at the thoracolumbar junction (T11–L2), where the distal spinal cord, conus medullaris (CM), and cauda equina (CE) are located [1,2,3,4]
Two hundreds and fifty-four patients with traumatic spinal cord injuries (SCIs) at thoracolumbar junction were consecutively admitted in our department between January 2011 and February 2017, of which 190 patients were included in the present study, whereas 64 were excluded because they could not afford or refused to undergo urodynamic tests
One hundred and ninety patients were assigned into five groups, according to their SCI modality, as analyzed by the processes described above (Table 1)
Summary
Most spinal trauma occurs at the thoracolumbar junction (T11–L2), where the distal spinal cord, conus medullaris (CM), and cauda equina (CE) are located [1,2,3,4]. Heterogeneity among traumatic spinal cord injuries at the thoracolumbar junction: helping select. Reporting of unreliable therapeutic effects, or the dismissing of useful therapies [18]. Before new SCI treatments can be brought to clinical trials, it is necessary to distinguish and categorize the pathological aspects of traumatic SCI at the thoracolumbar junction
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