BACKGROUND: In the elderly, the cervical vertebrae will appear with different degrees of spinal stenosis caused by various factors. Notably, the incidence of cervical spinal cord injury without fracture or dislocation is high, accounting for 3%-16% of cervical spinal cord injury.OBJECTIVE: To explore the efficacy of MRI in the diagnosis and prognosis of cervical spinal cord injury without fracture or dislocation, and to analyze the influencing factors for surgical effectiveness.METHODS: Fifty-one patients with cervical spinal cord injury without fracture or dislocation in Zibo Central Hospital from August 2014 to June 2016 were analyzed retrospectively. All the patients underwent anterior, posteror, or anterior-posterior fusion, respectively, and then the intraoperative ligament injury and MRI images were compared. The age, injury type, spinal cord injury type revealed on MRI, time from injury to hospital, signal length of spinal cord injury,American Spinal injury Association grade, degree of cervical stenosis, whether hormone used or not within 8 hours after injury, time from injury to surgery, and surgical approaches were analyzed based on univariate analysis and multivariate analysis by Logistic regression analysis.RESULTS AND CONCLUSION: (1) MRI showed more comprehensive damage of the spinal cord and intervertebral disc ligament complex than the intraoperative findings (χ2=5.966,P < 0.05), and the cervical spinal cord injury was related to the injury of the corresponding intervertebral disc ligament complex (χ2=1.53, P > 0.05). (2) Univariate analysis results showed that the spinal cord injury type revealed on MRI, signal length of spinal cord injury, American Spinal injury Association grade, degrees of cervical stenosis, whether hormone used or not within 8 hours after injury, and time from injury to surgery were related to the functional recovery of spinal cord (P < 0.01). (3) Multivariate analysis results indicated that the type revealed on MRI, signal length of spinal cord injury and degrees of cervical stenosis were significantly related to the functional recovery of spinal cord (P < 0.05). (4) These results suggest that MRI has a high tissue resolution, so it plays an important role in the diagnosis of cervical spinal cord injury without fracture or dislocation.Moreover, the degrees of spinal cord injury and spinal stenosis, as well as operation time are main factors for curative efficacy.