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Nat Rev Neurol. 2019 Dec;15(12):718-731. doi: 10.1038/s41582-019-0270-5. Epub 2019 Oct 31.

Traumatic and nontraumatic spinal cord injury: pathological insights from neuroimaging.

Author information

1
Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
2
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
3
Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK.
4
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
5
NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.
6
Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
7
Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.
8
Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland. patrick.freund@balgrist.ch.
9
Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK. patrick.freund@balgrist.ch.
10
Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. patrick.freund@balgrist.ch.
11
Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK. patrick.freund@balgrist.ch.
12
Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. patrick.freund@balgrist.ch.

Abstract

Pathophysiological changes in the spinal cord white and grey matter resulting from injury can be observed with MRI techniques. These techniques provide sensitive markers of macrostructural and microstructural tissue integrity, which correlate with histological findings. Spinal cord MRI findings in traumatic spinal cord injury (tSCI) and nontraumatic spinal cord injury - the most common form of which is degenerative cervical myelopathy (DCM) - have provided important insights into the pathophysiological processes taking place not just at the focal injury site but also rostral and caudal to the spinal injury. Although tSCI and DCM have different aetiologies, they show similar degrees of spinal cord pathology remote from the injury site, suggesting the involvement of similar secondary degenerative mechanisms. Advanced quantitative MRI protocols that are sensitive to spinal cord pathology have the potential to improve diagnosis and, more importantly, predict outcomes in patients with tSCI or nontraumatic spinal cord injury. This Review describes the insights into tSCI and DCM that have been revealed by neuroimaging and outlines current activities and future directions for the field.

PMID:
31673093
DOI:
10.1038/s41582-019-0270-5

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