Objective: To investigate the usefulness of the combination of neurological findings and magnetic resonance imaging (MRI) as a prognostic predictor in patients with motor complete cervical spinal cord injury (CSCI) in the acute phase.

Design: A cross-sectional analysis

Setting: Department of Orthopaedic Surgery, Spinal Injuries Center

Participants/Methods: Forty-two patients with an initial diagnosis of motor complete CSCI (AIS A, n = 29; AIS B, n = 13) within 72 h after injury were classified into the recovery group (Group R) and the non-recovery group (Group N), based on the presence or absence of motor recovery (conversion from AIS A/B to C/D) at three months after injury, respectively. The Neurological Level of Injury (NLI) at the initial diagnosis was investigated and the presumptive primary injured segment of the spinal cord was inferred from MRI performed at the initial diagnosis. We investigated whether or not the difference between the presumptive primary injured segment and the NLI exceeded one segment. The presence of a difference between the presumptive primary injured segment and the NLI was compared between Groups R and N.

Results: The number of cases with the differences between the presumptive primary injured segment and the NLI was significantly higher in Group N than in Group R.

Conclusion: The presence of differences between the presumptive primary injured segment and the NLI might be a poor improving prognostic predictor for motor complete CSCI. The NLI may be useful for predicting the recovery potential of patients with motor complete CSCI when combined with the MRI findings.

目的：探讨神经学表现和磁共振成像（MRI）相结合作为急性期运动性完全性颈脊髓损伤（CSCI）患者预后预测指标的有用性。

设计：横截面分析

地点：脊柱损伤中心骨科

参与者/方法： 42 名初步诊断为运动完全性 CSCI 的患者（AIS A，n  = 29；AIS B，n = 13) 受伤后 72 小时内根据是否有运动恢复（从 AIS A/B 转换为 C/D）分为恢复组（R 组）和非恢复组（N 组）分别在受伤后三个月。对初步诊断时的神经损伤水平 (NLI) 进行了调查，并根据初步诊断时进行的 MRI 推断出假定的脊髓原发性损伤段。我们调查了假定原发性损伤节段与 NLI 之间的差异是否超过了一个节段。在 R 组和 N 组之间比较推定原发性损伤节段和 NLI 之间存在差异。

结果： N 组推定原发性损伤节段与 NLI 之间存在差异的病例数明显高于 R 组。

结论：推定的原发性损伤节段与 NLI 之间存在差异可能是运动完全性 CSCI 的不良改善预后预测因子。当结合 MRI 结果时，NLI 可能有助于预测运动完全性 CSCI 患者的恢复潜力。