PMID- 28362913
OWN - NLM
STAT- MEDLINE
DCOM- 20171207
LR  - 20220318
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Print)
IS  - 0148-396X (Linking)
VI  - 80
IP  - 4
DP  - 2017 Apr 1
TI  - Intramedullary Lesion Length on Postoperative Magnetic Resonance Imaging is a 
      Strong Predictor of ASIA Impairment Scale Grade Conversion Following 
      Decompressive Surgery in Cervical Spinal Cord Injury.
PG  - 610-620
LID - 10.1093/neuros/nyw053 [doi]
AB  - BACKGROUND: Evidence indicates that, over time, patients with spinal cord injury 
      (SCI) improve neurologically in various degrees. We sought to further investigate 
      indicators of grade conversion in cervical SCI. OBJECTIVE: To detect predictors 
      of ASIA impairment scale (AIS) grade conversion in SCI following surgical 
      decompression. METHODS: In a retrospective study, demographics, clinical, 
      imaging, and surgical data from 100 consecutive patients were assessed for 
      predictors of AIS grade conversion. RESULTS: American Spinal Injury Association 
      motor score was 17.1. AIS grade was A in 52%, B in 29%, and C in 19% of patients. 
      Surgical decompression took place on an average of 17.6 h following trauma (</=12 h 
      in 51 and >12 h in 49). Complete decompression was verified by magnetic resonance 
      imaging (MRI) in 73 patients. Intramedullary lesion length (IMLL) on 
      postoperative MRI measured 72.8 mm, and hemorrhage at the injury epicenter was 
      noted in 71 patients. Grade conversion took place in 26.9% of AIS grade A 
      patients, 65.5% of AIS grade B, and 78.9% of AIS grade C. AIS grade conversion 
      had statistical relationship with injury severity score, admission AIS grade, 
      extent of decompression, presence of intramedullary hemorrhage, American Spinal 
      Injury Association motor score, and IMLL. A stepwise multiple logistic regression 
      analysis indicated IMLL was the sole and strongest indicator of AIS grade 
      conversion (odds ratio 0.950, 95% CI 0.931-0.969). For 1- and 10-mm increases in 
      IMLL, the model indicates 4% and 40% decreases, respectively, in the odds of AIS 
      grade conversion. CONCLUSION: Compared with other surrogates, IMLL remained as 
      the only predictor of AIS grade conversion.
CI  - (c) The Authors 2016. Published by Oxford University Press on behalf of The 
      Congress of Neurological Surgeons
FAU - Aarabi, Bizhan
AU  - Aarabi B
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
AD  - R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 
      Baltimore, Maryland.
FAU - Sansur, Charles A
AU  - Sansur CA
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
FAU - Ibrahimi, David M
AU  - Ibrahimi DM
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
FAU - Simard, J Marc
AU  - Simard JM
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
FAU - Hersh, David S
AU  - Hersh DS
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
FAU - Le, Elizabeth
AU  - Le E
AD  - Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, 
      Maryland.
FAU - Diaz, Cara
AU  - Diaz C
AD  - R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 
      Baltimore, Maryland.
FAU - Massetti, Jennifer
AU  - Massetti J
AD  - R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 
      Baltimore, Maryland.
FAU - Akhtar-Danesh, Noori
AU  - Akhtar-Danesh N
AD  - School of Nursing and Depart-ment of Clinical Epidemiology and Bio-statistics, 
      McMaster University, Hamilton, Ontario, Canada.
LA  - eng
GR  - R01 NS060801/NS/NINDS NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adult
MH  - Cervical Cord/diagnostic imaging/injuries/*surgery
MH  - Cervical Vertebrae/diagnostic imaging/*surgery
MH  - Decompression, Surgical/methods
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Retrospective Studies
MH  - Spinal Cord Injuries/diagnostic imaging/*surgery
MH  - Young Adult
PMC - PMC5748932
MID - NIHMS927450
OTO - NOTNLM
OT  - ASIA
OT  - Cervical spine
OT  - Decompression
OT  - MRI
OT  - Outcome
OT  - Spinal cord injury
EDAT- 2017/04/01 06:00
MHDA- 2017/12/08 06:00
PMCR- 2018/04/01
CRDT- 2017/04/01 06:00
PHST- 2015/11/08 00:00 [received]
PHST- 2016/11/14 00:00 [accepted]
PHST- 2017/04/01 06:00 [entrez]
PHST- 2017/04/01 06:00 [pubmed]
PHST- 2017/12/08 06:00 [medline]
PHST- 2018/04/01 00:00 [pmc-release]
AID - 2742540 [pii]
AID - nyw053 [pii]
AID - 10.1093/neuros/nyw053 [doi]
PST - ppublish
SO  - Neurosurgery. 2017 Apr 1;80(4):610-620. doi: 10.1093/neuros/nyw053.