Predictive Values of Magnetic Resonance Imaging Features for Tracheostomy in Traumatic Cervical Spinal Cord Injury
- Author:
Tae Seok JEONG
1
;
Sang Gu LEE
;
Woo Kyung KIM
;
Yong AHN
;
Seong SON
Author Information
- Publication Type:Original Article
- Keywords: Spine; Spinal cord; Injuries; Tracheostomy; Magnetic resonance imaging
- MeSH: Cervical Cord; Humans; Magnetic Resonance Imaging; Multivariate Analysis; Osteophyte; Retrospective Studies; Spinal Cord; Spinal Injuries; Spine; Tracheostomy
- From:Journal of Korean Neurosurgical Society 2018;61(5):582-591
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury.METHODS: This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters.RESULTS: Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50–60% and ten times higher between 60–70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20–30 mm and fourteen times higher between 40–50 mm.CONCLUSION: The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ≥50%, a lesion length ≥20 mm, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.
