Heterogeneity among traumatic spinal cord injuries at the thoracolumbar junction: helping select patients for clinical trials release_orcoxgnrb5fytggjq2iipuwrre

by Shu-Jia Liu, Qiang Wang, He-Hu Tang, Jin-Zhu Bai, Fang-Yong Wang, Zhen Lv, Shi-Zheng Chen, Jie-Sheng Liu, Yi Hong, Jun-Wei Zhang

Abstract

Retrospective analysis. China Rehabilitation Research Center, Beijing, China. A retrospective study that documents the modalities and clarifies the heterogeneity among spinal cord injuries (SCIs) caused by trauma to the thoracolumbar vertebral junction. X-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. The 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). The 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.
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Published in Spinal Cord by Springer Science and Business Media LLC
ISSN-L 1362-4393
Volume 57
Issue 11
Page(s) 972-978
Release Date 2019-06-25
Publisher Springer Science and Business Media LLC
Primary Language en (lookup)

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Date   2019-06-25
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ISSN-L:  1362-4393
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