Abstract：
OBJECTIVE: We aimed to explore the prognostic significance of preoperative magnetic resonance imaging (MRI) variables and novel inflammatory indicators in predicting neurological recovery post-cervical traumatic spinal cord injury (TSCI) in the study.
METHODS: We enrolled a total of 244 patients diagnosed with acute cervical TSCI from 2 hospitals and evaluated the prognostic value of MRI variables (intramedullary hemorrhage, intramedullary lesion length [IMLL], maximum spinal cord compression, and maximum canal compromise [MCC]) and novel inflammatory indicators (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and systemic immune-inflammatory index) in patients with acute cervical TSCI.
RESULTS: Among the 244 patients, 140 (57.38%) exhibited improved AIS grade conversion at 1-year follow-up. The results revealed intramedullary hemorrhage, IMLL, MCC, neutrophils, and NLR were significantly different compared with follow-up AIS grade. Furthermore, IMLL, MCC, white blood cells, neutrophils, NLR, and lymphocyte-to-monocyte ratio correlated with the follow-up AIS grade by Spearman\'s correlation analysis. Multivariate analysis showed IMLL, intramedullary hemorrhage, NLR, and admission AIS grade emerged as independent predictors of AIS grade conversion. The receiver operating characteristic curve analysis showed that the novel model (combination of MRI variables, NLR, and admission AIS grade) produced a larger area under the curve compared with using only intramedullary hemorrhage, IMLL, NLR, or admission AIS grade individually.
CONCLUSIONS: Intramedullary hemorrhage and IMLL and NLR are predictors of AIS grade conversion after cervical TSCI. Therefore, we suggest the combination of MRI variables and NLR for the prognostic prediction of AIS grade conversion in patients with cervical TSCI.
METHODS: We enrolled a total of 244 patients diagnosed with acute cervical TSCI from 2 hospitals and evaluated the prognostic value of MRI variables (intramedullary hemorrhage, intramedullary lesion length [IMLL], maximum spinal cord compression, and maximum canal compromise [MCC]) and novel inflammatory indicators (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and systemic immune-inflammatory index) in patients with acute cervical TSCI.
RESULTS: Among the 244 patients, 140 (57.38%) exhibited improved AIS grade conversion at 1-year follow-up. The results revealed intramedullary hemorrhage, IMLL, MCC, neutrophils, and NLR were significantly different compared with follow-up AIS grade. Furthermore, IMLL, MCC, white blood cells, neutrophils, NLR, and lymphocyte-to-monocyte ratio correlated with the follow-up AIS grade by Spearman\'s correlation analysis. Multivariate analysis showed IMLL, intramedullary hemorrhage, NLR, and admission AIS grade emerged as independent predictors of AIS grade conversion. The receiver operating characteristic curve analysis showed that the novel model (combination of MRI variables, NLR, and admission AIS grade) produced a larger area under the curve compared with using only intramedullary hemorrhage, IMLL, NLR, or admission AIS grade individually.
CONCLUSIONS: Intramedullary hemorrhage and IMLL and NLR are predictors of AIS grade conversion after cervical TSCI. Therefore, we suggest the combination of MRI variables and NLR for the prognostic prediction of AIS grade conversion in patients with cervical TSCI.
摘要：
我们旨在探讨术前磁共振成像（MRI）变量和新型炎症指标在预测颈椎创伤性脊髓损伤（TSCI）后神经功能恢复中的预后意义。我们共纳入了来自两家医院的244例诊断为急性宫颈TSCI的患者，并评估了MRI变量的预后价值（髓内出血，髓内病变长度(IMLL),最大脊髓压迫（MSCC），和最大管损害（MCC））和新的炎症指标（中性粒细胞与淋巴细胞比率（NLR），血小板与淋巴细胞比率（PLR），淋巴细胞与单核细胞比率（LMR），和全身免疫炎症指数（SII））在急性宫颈TSCI患者中。在244名患者中，140（57.38%）在1年的随访中表现出改善的AIS等级转换。结果显示髓内出血,IMLL,MCC,中性粒细胞，NLR与随访AIS等级相比有显著差异。此外，IMLL,MCC,WBC,中性粒细胞，NLR,通过Spearman的相关分析，LMR与随访AIS等级相关。多变量分析显示IMLL，髓内出血,NLR和入学AIS等级成为AIS等级转换的独立预测因子。受试者工作特性曲线(ROC)分析表明，新模型(MRI变量组合，与仅使用髓内出血相比，NLR和入院AIS等级）产生了更大的曲线下面积，IMLL,NLR或入学AIS等级单独。总之,髓内出血和IMLL和NLR是宫颈TSCI后AIS等级转换的预测因子。因此,我们建议MRI变量和NLR联合预测宫颈TSCI患者AIS分级转换的预后.
