Background The majority of patients with spinal cord injury (SCI) have anatomically incomplete lesions and present with preserved tissue bridges, yet their outcomes vary. Objective To assess the predictive value of the anatomical location (ventral/dorsal) and width of preserved midsagittal tissue bridges for American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade conversion and SCI patient stratification into recovery-specific subgroups. Methods This retrospective longitudinal study includes 70 patients (56 men, age: 52.36 ± 18.58 years) with subacute (ie, 1 month) SCI (45 tetraplegics, 25 paraplegics), 1-month neuroimaging data, and 1-month and 12-month clinical data. One-month midsagittal T2-weighted scans were used to determine the location and width of tissue bridges. Their associations with functional outcomes were assessed using partial correlation and unbiased recursive partitioning conditional inference tree (URP-CTREE). Results Fifty-seven (81.4%) of 70 patients had tissue bridges (2.53 ± 2.04 mm) at 1-month post-SCI. Larger ventral (P = .001, r = 0.511) and dorsal (P < .001, r = 0.546) tissue bridges were associated with higher AIS conversion rates 12 months post-SCI (n = 39). URP-CTREE analysis identified 1-month ventral tissue bridges as predictors of 12-month total motor scores (0.4 mm cutoff, P = .008), recovery of upper extremity motor scores at 12 months (1.82 mm cutoff, P = .002), 12-month pin-prick scores (1.4 mm cutoff, P = .018), and dorsal tissue bridges at 1 month as predictors of 12-month Spinal Cord Independence Measure scores (0.5 mm cutoff, P = .003). Conclusions Midsagittal tissue bridges add predictive value to baseline clinical measures for post-SCI recovery. Based on tissue bridges’ width, patients can be classified into subgroups of clinical recovery profiles. Midsagittal tissue bridges provide means to optimize patient stratification in clinical trials.

中文翻译：

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中矢状组织桥对脊髓损伤后功能恢复的预测价值

背景 大多数脊髓损伤 (SCI) 患者具有解剖学上不完整的病变，并存在保留的组织桥，但他们的结果各不相同。目的 评估保留的正中矢状组织桥的解剖位置（腹侧/背侧）和宽度对美国脊髓损伤协会 (ASIA) 损伤量表 (AIS) 等级转换和 SCI 患者分层到恢复特定亚组的预测价值。方法 这项回顾性纵向研究包括 70 名亚急性（即 1 个月）SCI（45 名四肢瘫痪患者，25 名截瘫患者）、1 个月神经影像学数据以及 1 个月和 12 个月的亚急性（即 18.58 岁）患者（56 名男性，临床数据。使用一个月的正中矢状 T2 加权扫描来确定组织桥的位置和宽度。使用偏相关和无偏递归分区条件推理树（URP-CTREE）评估它们与功能结果的关联。结果 70 名患者中有 57 名 (81.4%) 在 SCI 后 1 个月有组织桥 (2.53 ± 2.04 mm)。较大的腹侧（P = .001，r = 0.511）和背侧（P < .001，r = 0.546）组织桥与 SCI 后 12 个月（n = 39）更高的 AIS 转换率相关。URP-CTREE 分析将 1 个月腹侧组织桥确定为 12 个月总运动评分（0.4 毫米临界值，P = .008）、12 个月时上肢运动评分恢复（1.82 毫米临界值，P = .002）的预测因子、12 个月针刺评分（1.4 毫米截断值，P = .018）和 1 个月时的背侧组织桥作为 12 个月脊髓独立测量评分的预测因子（0.5 毫米截断值，P = .003）。结论 中矢状组织桥为 SCI 后恢复的基线临床测量增加了预测价值。根据组织桥的宽度，患者可以分为临床恢复概况的亚组。中矢状组织桥提供了在临床试验中优化患者分层的方法。