Relationship between magnetic resonance imaging findings and spinal cord injury in extension injury of the cervical spine

  • Kyung-Jin Song
  • Jong Hyun Ko
  • Byung-Wan ChoiEmail author
Original Article • SPINE - FRACTURES



The purpose of this study was to determine the relationship between magnetic resonance imaging (MRI) findings and neurologic symptoms in cervical spine extension injury and to analyze the MRI parameters associated with neurologic outcome.

Materials and methods

This study included 102 patients with cervical spine extension injury, whose medical records and MRI scans at the time of injury were available. Quantitative MRI parameters such as maximum spinal canal compression (MSCC), maximum cord compromise (MCC), and lesion length showing intramedullary signal changes were measured. Furthermore, intramedullary hemorrhage, spinal cord edema, and soft tissue damage were evaluated. Fisher’s exact test was used for a cross-analysis between the MRI findings and the three American Spinal Injury Association category groups depending on the severity level of neurologic injury: complete (category A), incomplete (categories B–D), and normal (category E).


MSCC accounted for 23.05, 19.5, and 9.94 % for the complete, incomplete, and normal AIS categories, respectively, without showing statistically significant differences (P = 0.085). MCC was noted in 22.05, 15.32, and 9.2 %, respectively, with the complete-injury group (AIS category A) showing significantly higher. In particular, cases of complete injury had >15 % compression, accounting for 87.5 % (P < 0.001). The mean intramedullary lesion length was significantly higher in complete-injury patients than in incomplete-injury patients (24.22 vs. 8.24 mm). Intramedullary hemorrhage and spinal cord edema were significantly more frequently observed in complete-injury cases (P < 0.001). The incidence of complete injury was proportional to the severity of soft tissue damage.


MCC, intramedullary lesion length, intramedullary hemorrhage, and spinal cord edema were MRI parameters associated with poor neurologic outcomes in patients with cervical spine extension injury.


Cervical spine Extension injury MRI ASIA score 



This study did not receive any benefits from a commercial entity related directly or indirectly to the subject of this manuscript.

Compliance with ethical standards

Conflict of interest

All authors (Song KJ, Ko JH, Choi BW) declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The present study was approved by our institutional review board.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Biomedical Research Institute of Chonbuk National University HospitalChonbuk National University Medical SchoolJeonjuRepublic of Korea
  2. 2.Department of Orthopedic Surgery, Haeundae Paik HospitalInje UniversityBusanRepublic of Korea

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