Prognostic value of early magnetic resonance imaging in the morbidity and mortality of traumatic spinal cord injury.

OBJECTIVE:To assess in individuals with traumatic spinal cord injury (TSCI) the relationship between mortality and need for ICU and early magnetic resonance imaging (MRI), analyzing spinal parenchymal alterations, disruption of vertebral ligaments (DVL) and spinal cord compression (SCC). DESIGN:Retrospective study. SETTING:Third-level hospital, Spinal Cord Injury Unit and ICU. PATIENTS:Individuals with acute TSCI between 2010 and 2019. INTERVENTION:Analysis of MRI performed in the first 72 h. VARIABLES OF INTEREST:Admission to ICU and mortality. RESULTS:269 cases collected. The pattern that demonstrated higher mortality was cord hemorrhage (16.7%) for 12.5% ​​of single-level edema and 6.5% of multilevel edema (p = 0.125). The same happened with ICU admissions: 69.0% in hemorrhage, 60.2% in multilevel edema and 46.3% in short edema (p = 0.018). Analyzing CCM, mortality was 13.4% with 59.2% of ICU admissions, for 2.2% and 42.2% of individuals without cord compression (p = 0.020 and p = 0.003). The figures of death and ICU admission among cord injuries with DVL were 15.0% and 67.3%, for 6.2% and 44.4% of the individuals without DLV (p < 0.001 and p = 0.013). CONCLUSIONS:The presence of spinal cord hemorrhage, SCC and DVL was associated with a higher admission in ICU. A significant increase in mortality was observed in cases with SCC and DVL.