Evaluation of the relationship between MRI and electrodiagnostic tests in acute traumatic spinal cord injury

Purpose: Neuroimaging and electrodiagnostic studies are used to evaluate the changes in the spinal cord after trauma, both for clinical and research purposes. The aim of the present study was to find a correlation between the MRI and electrodiagnostic testing for acute traumatic spinal cord injury (SCI) over different points in time. Methods: Thirty-five patients with acute SCI presenting within 48 h of injury and completing a minimum of 6 months of regular follow-up comprised the study population. Patients were examined clinically for neurological involvement as per international guidelines. Magnetic resonance imaging (MRI) spine and electrodiagnostic testing of both lower limbs [two motor (tibial and peroneal) and one sensory (sural) nerve] and five muscles (Iliopsoas, Vastus medialis, Tibialis anterior, Gastrocnemius, and Extensor hallucis longus (EHL)] were done at admission, 3 and 6 months. Results: Quantitative MRI parameters [maximum spinal cord compression (MSCC), maximum canal compromise (MCC), and lesion length (LL)] showed a significant correlation to motor nerve conduction velocity and sensory nerve conduction velocity at all points in time. Electromyography of tested muscles at admission showed a significant correlation (Spearman’s correlation test) with MRI quantitative parameters (−0.818 to −0.510); stenosis (−0.564 to −0.347) except right EHL for peak to peak amplitude; and disk herniation (−0.427 to −0.339) except tibialis anterior for recruitment of motor unit potential (MUP) and iliopsoas, right gastrocnemius, and EHL for peak to peak amplitude. This correlation remained significant even at 3 and 6 months post-acute SCI. Conclusion: The quantitative MRI parameters, along with a few of the qualitative parameters, show a significant correlation with electrodiagnostic features at different points in acute traumatic SCI.