ROLE OF MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF SPINAL TRAUMA: A CROSS-SECTIONAL STUDY

Abstract

Background: Spinal trauma remains a leading cause of morbidity and long-term neurological disability worldwide, particularly among young and middle-aged adults. Early and accurate evaluation of spinal cord and associated soft tissue injuries is essential to prevent secondary neurological deterioration and to guide appropriate management. Conventional imaging modalities primarily assess osseous injuries and may fail to detect clinically significant cord and ligamentous damage. Magnetic Resonance Imaging offers superior soft tissue contrast and has emerged as a key modality for comprehensive spinal trauma assessment and prognostication.

Objective: To evaluate the role of Magnetic Resonance Imaging in the assessment of spinal trauma and to determine the association between MRI findings and neurological outcomes.

Methods: A cross-sectional analytical study was conducted on 210 patients with suspected acute spinal trauma who underwent MRI evaluation. Demographic data, mechanism of injury, spinal level involved, and time to imaging were recorded. MRI was performed using a 1.5 Tesla scanner with standard sagittal and axial T1-weighted, T2-weighted, STIR, and gradient echo sequences when indicated. Neurological status was assessed at presentation using the American Spinal Injury Association impairment scale. Associations between MRI findings and neurological deficits were analyzed using Chi-square testing, followed by multivariable logistic regression to identify independent predictors.

Results: The study population was predominantly male (69.5%), with road traffic accidents accounting for 45.7% of injuries. Cervical spine involvement was observed in 35.2% of patients. MRI demonstrated vertebral body fractures in 61.0%, spinal cord edema in 45.7%, cord contusion in 35.2%, cord hemorrhage in 15.2%, ligamentous injury in 39.0%, and paraspinal soft tissue injury in 49.5%. Neurological deficits (ASIA A–D) were present in a significantly higher proportion of patients with MRI-detected cord abnormalities (p < 0.001). On multivariable analysis, spinal cord hemorrhage (AOR 7.69; 95% CI 3.12–18.96), cord contusion (AOR 3.98; 95% CI 2.04–7.77), and cord edema (AOR 3.06; 95% CI 1.66–5.63) were independent predictors of neurological deficit.

Conclusion: Magnetic Resonance Imaging plays a central role in the accurate diagnosis and prognostic assessment of spinal trauma by reliably identifying spinal cord and soft tissue injuries. Its integration into routine trauma evaluation enhances clinical decision-making and supports optimized patient management.