{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T20:00:17Z","timestamp":1794513617129,"version":"4.9.1"},"reference-count":121,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Evidence indicates that, over time, patients with spinal cord injury (SCI) improve neurologically in various degrees. We sought to further investigate indicators of grade conversion in cervical SCI.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    To detect predictors of ASIA impairment scale (AIS) grade conversion in SCI following surgical decompression.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    In a retrospective study, demographics, clinical, imaging, and surgical data from 100 consecutive patients were assessed for predictors of AIS grade conversion.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    American Spinal Injury Association motor score was 17.1. AIS grade was A in 52%, B in 29%, and C in 19% of patients. Surgical decompression took place on an average of 17.6 h following trauma (\u226412 h in 51 and &gt;12 h in 49). Complete decompression was verified by magnetic resonance imaging (MRI) in 73 patients. Intramedullary lesion length (IMLL) on postoperative MRI measured 72.8 mm, and hemorrhage at the injury epicenter was noted in 71 patients. Grade conversion took place in 26.9% of AIS grade A patients, 65.5% of AIS grade B, and 78.9% of AIS grade C. AIS grade conversion had statistical relationship with injury severity score, admission AIS grade, extent of decompression, presence of intramedullary hemorrhage, American Spinal Injury Association motor score, and IMLL. A stepwise multiple logistic regression analysis indicated IMLL was the sole and strongest indicator of AIS grade conversion (odds ratio 0.950, 95% CI 0.931-0.969). For 1- and 10-mm increases in IMLL, the model indicates 4% and 40% decreases, respectively, in the odds of AIS grade conversion.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    Compared with other surrogates, IMLL remained as the only predictor of AIS grade conversion.\n                  <\/jats:p>","DOI":"10.1093\/neuros\/nyw053","type":"journal-article","created":{"date-parts":[[2017,2,15]],"date-time":"2017-02-15T15:07:29Z","timestamp":1487171249000},"page":"610-620","source":"Crossref","is-referenced-by-count":147,"title":["Intramedullary Lesion Length on Postoperative Magnetic Resonance Imaging is a Strong Predictor of ASIA Impairment Scale Grade Conversion Following Decompressive Surgery in Cervical Spinal Cord Injury"],"prefix":"10.1227","volume":"80","author":[{"given":"Bizhan","family":"Aarabi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"},{"name":"R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Sansur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Ibrahimi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Marc","family":"Simard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Diaz","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Massetti","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noori","family":"Akhtar-Danesh","sequence":"additional","affiliation":[{"name":"School of Nursing and Depart-ment of Clinical Epidemiology and Bio-statistics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,4]]},"reference":[{"issue":"(1)","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1589\/jpts.26.67","article-title":"Analysis of the factors influencing functional outcomes in patients with spinal cord injury","volume":"26","author":"Milicevic","year":"2014","journal-title":"J Phys Ther Sci"},{"issue":"(10)","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1089\/neu.2004.21.1355","article-title":"A global perspective on spinal cord injury epidemiology","volume":"21","author":"Ackery","year":"2004","journal-title":"J Neurotrauma"},{"issue":"(6)","key":"bib3-20231011","first-page":"36","article-title":"Spinal cord injury: a ten-year report","volume":"93","author":"Buchanan","year":"1990","journal-title":"Pa Med"},{"issue":"(3)","key":"bib4-20231011","first-page":"248","article-title":"Causes of death during the first 12 years after spinal cord injury","volume":"74","author":"DeVivo","year":"1993","journal-title":"Arch Phys Med Rehabil"},{"issue":"(11)","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/S0003-9993(99)90252-6","article-title":"Recent trends in mortality and causes of death among persons with spinal cord injury","volume":"80","author":"DeVivo","year":"1999","journal-title":"Arch Phys Med Rehabil"},{"issue":"(4)","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1179\/2045772311Y.0000000017","article-title":"Epidemiological profile of 239 traumatic spinal cord injury cases over a period of 12 years in Tianjin, China","volume":"34","author":"Feng","year":"2011","journal-title":"J Spinal Cord Med"},{"issue":"(1)","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"e84733","DOI":"10.1371\/journal.pone.0084733","article-title":"Epidemiology of spinal cord injuries and risk factors for complete injuries in Guangdong, China: a retrospective study","volume":"9","author":"Yang","year":"2014","journal-title":"PloS One"},{"issue":"(3)","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/scrt219","article-title":"Human conditionally immortalized neural stem cells improve locomotor function after spinal cord injury in the rat","volume":"4","author":"Amemori","year":"2013","journal-title":"Stem Cell Res Ther"},{"issue":"(5)","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.stem.2011.04.012","article-title":"Target populations for first-in-human embryonic stem cell research in spinal cord injury","volume":"8","author":"Bretzner","year":"2011","journal-title":"Cell Stem Cell"},{"issue":"(5274)","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1126\/science.273.5274.510","article-title":"Spinal cord repair in adult paraplegic rats: partial restoration of hind limb function","volume":"273","author":"Cheng","year":"1996","journal-title":"Science"},{"issue":"(1)","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"49","DOI":"10.47102\/annals-acadmedsg.V36N1p49","article-title":"Recovery and regeneration after spinal cord injury: a review and summary of recent literature","volume":"36","author":"Lim","year":"2007","journal-title":"Ann Acad Med Singapore"},{"issue":"(3)","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3171\/jns.1971.35.3.0263","article-title":"The microvasculature in transitory traumatic paraplegia. 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