@article{ref1,
title="Evaluating the severity and prognosis of acute traumatic cervical spinal cord injury: a novel classification using diffusion tensor imaging and diffusion tensor  tractography",
journal="Spine",
year="2020",
author="Guo, Xiaodong and Liu, Yuan and Zhu, Fengzhao and Kong, Xiangchuang and Wang, Yulong and Zeng, Lian and Yang, Lian and Jing, Xirui and Chen, Kaifang and Yao, Sheng",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="STUDY DESIGN: Retrospective observational cohort study. <br><br>OBJECTIVE: We explored the relationship between Diffusion tensor imaging (DTI) parameters and prognosis in  patients with acute traumatic cervical spinal cord injury (ATCSCI). SUMMARY OF  BACKGROUND DATA: DTI has been used to diagnose spinal cord injury; nevertheless, its  role remains controversial. <br><br>METHODS: We analyzed retrospectively 24 patients with  ATCSCI who were examined using conventional T2-weighted imaging and DTI. Fractional  anisotropy (FA) and apparent diffusion coefficient (ADC) were recorded at the  injured site. DTT was used to measure the spinal cord white matter fiber volume  (MWFV). American Spinal Injury Association (ASIA) grades were recorded. Correlations  between DTI parameters and ASIA scores were evaluated using Spearman correlation  coefficients. <br><br>RESULTS: FA values at injured sites were significantly lower than  those of the control group, while ADC values in injured and control groups were not  significantly different. DTT revealed that ATCSCI could be divided into four types:  Type A1-complete rupture of spinal cord white matter fiber (MWF); Type A2-partial  rupture of MWF; Type B-most MWF retained with severe compression or abnormal fiber  conduction direction; and Type C-MWF basically complete with slight compression. Preoperative physical examinations revealed complete injury (ASIA A) in patients  with A1 (n = 4) and A2 (n = 4). The ASIA grades or scores of A2 were improved to  varying degrees, whereas there was no significant improvement in A1. FA values and  MWFV of ASIA B, C, and D were significantly higher than those of ASIA A. FA and MWFV  were correlated with ASIA motor score (AMS) preoperatively and at final follow-up. <br><br>CONCLUSION: We propose a classification for the severity of ATCSCI based on DTI and  DTT that may explain why some patients with ASIA A recover while others do not.Level  of Evidence: 4.<p /> <p>Language: en</p>",
language="en",
issn="0362-2436",
doi="10.1097/BRS.0000000000003923",
url="http://dx.doi.org/10.1097/BRS.0000000000003923"
}