PMID- 35046538
OWN - NLM
STAT- MEDLINE
DCOM- 20220622
LR  - 20230210
IS  - 1476-5624 (Electronic)
IS  - 1362-4393 (Linking)
VI  - 60
IP  - 6
DP  - 2022 Jun
TI  - Acute hyperextension myelopathy in children: Radiographic predictors of clinical 
      improvement.
PG  - 498-503
LID - 10.1038/s41393-021-00739-w [doi]
AB  - STUDY DESIGN: Retrospective case series SETTING: Three hospitals in China. 
      OBJECTIVE: Previous research indicates that only neurological status on admission 
      determines prognosis of acute hyperextension myelopathy (AHM). The object of this 
      study is to analyze other unfavorable predictors of AHM in children. METHODS: The 
      clinical data of children with AHM were retrospectively analyzed. The ASIA 
      impairment scale (AIS) grade was recorded upon admission and at last follow-up. 
      Intramedullary lesion length (IMLL) was measured in the sagittal T2-weighted 
      imaging (T2WI) within two weeks after onset; gadolinium enhancement in the cord 
      was recorded for each patient. Relationships among AIS grade, IMLL, gadolinium 
      enhancement in the cord, and clinical improvement were assessed. RESULTS: A total 
      of 33 patients were included in this retrospective study. IMLL between complete 
      and incomplete injury was significantly different (p < 0.01) in the subacute 
      stage, and no difference was observed in the acute stage. Correlation analysis 
      revealed that AIS grade on admission (r = 0.906, p < 0.001) was significantly 
      positively correlated with clinical improvement. IMLL (r = -0.608, p < 0.001) and 
      abnormal gadolinium enhancement (r = -0.816, p < 0.001) in the cord in the 
      subacute stage were significantly negatively correlated with clinical 
      improvement. There were no associations between IMLL in the acute stage and 
      clinical improvement (r = -0.248, p = 0.242). The statistically significant 
      predictors of clinical improvement were AIS grade on admission, IMLL in the 
      subacute stage, and abnormal gadolinium enhancement. CONCLUSION: IMLL in the 
      subacute stage and abnormal gadolinium enhancement in the cord are two other 
      prognostic predictors of AHM in children.
CI  - (c) 2021. The Author(s), under exclusive licence to International Spinal Cord 
      Society.
FAU - Wang, Yulong
AU  - Wang Y
AUID- ORCID: 0000-0002-0895-6010
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China.
FAU - Zeng, Lian
AU  - Zeng L
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China.
FAU - Zhu, Fengzhao
AU  - Zhu F
AD  - Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, Third Military 
      Medical University (Army Medical University), Chongqing, 400037, China.
FAU - Huang, Guixiong
AU  - Huang G
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China.
FAU - Wan, Yizhou
AU  - Wan Y
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China.
FAU - Yao, Sheng
AU  - Yao S
AD  - Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430030, Hubei, China.
FAU - Chen, Kaifang
AU  - Chen K
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China.
FAU - Guo, Xiaodong
AU  - Guo X
AUID- ORCID: 0000-0001-9429-457X
AD  - Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, 430022, China. 
      xiaodongguo@hust.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20220120
PL  - England
TA  - Spinal Cord
JT  - Spinal cord
JID - 9609749
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Cervical Vertebrae/surgery
MH  - Child
MH  - Contrast Media
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Retrospective Studies
MH  - *Spinal Cord Diseases
MH  - *Spinal Cord Injuries/pathology
EDAT- 2022/01/21 06:00
MHDA- 2022/06/23 06:00
CRDT- 2022/01/20 05:56
PHST- 2021/07/21 00:00 [received]
PHST- 2021/12/08 00:00 [accepted]
PHST- 2021/12/08 00:00 [revised]
PHST- 2022/01/21 06:00 [pubmed]
PHST- 2022/06/23 06:00 [medline]
PHST- 2022/01/20 05:56 [entrez]
AID - 10.1038/s41393-021-00739-w [pii]
AID - 10.1038/s41393-021-00739-w [doi]
PST - ppublish
SO  - Spinal Cord. 2022 Jun;60(6):498-503. doi: 10.1038/s41393-021-00739-w. Epub 2022 
      Jan 20.