Predictive Values of Magnetic Resonance Imaging Features for Tracheostomy in Traumatic Cervical Spinal Cord Injury
- Authors
- Jeong, Tae Seok; Lee, Sang Gu; Kim, Woo Kyung; Ahn, Yong; Son, Seong
- Issue Date
- Sep-2018
- Publisher
- KOREAN NEUROSURGICAL SOC
- Keywords
- Spine; Spinal cord; Injuries; Tracheostomy; Magnetic resonance imaging
- Citation
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, v.61, no.5, pp.582 - 591
- Journal Title
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
- Volume
- 61
- Number
- 5
- Start Page
- 582
- End Page
- 591
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3377
- DOI
- 10.3340/jkns.2017.0222
- ISSN
- 2005-3711
- Abstract
- Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC =50%, a lesion length >= 20 mm, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.
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