{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:46:46Z","timestamp":1792622806290,"version":"4.5.0"},"reference-count":82,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Studies of preclinical spinal cord injury (SCI) in rodents indicate that expansion of intramedullary lesions (IMLs) seen on MR images may be amenable to neuroprotection. In patients with subaxial SCI and motor-complete American Spinal Injury Association (ASIA) Impairment Scale (AIS) Grade A or B, IML expansion has been shown to be approximately 900 \u03bcm\/hour. In this study, the authors investigated IML expansion in a cohort of patients with subaxial SCI and AIS Grade A, B, C, or D.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Seventy-eight patients who had at least 2 MRI scans within 6 days of SCI were enrolled. Data were analyzed by regression analysis.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In this cohort, the mean age was 45.3 years (SD 18.3 years), 73 patients were injured in a motor vehicle crash, from a fall, or in sport activities, and 77% of them were men. The mean Injury Severity Score (ISS) was 26.7 (SD 16.7), and the AIS grade was A in 23 patients, B in 7, C in 7, and D in 41. The mechanism of injury was distraction in 26 patients, compression in 22, disc\/osteophyte complex in 29, and Chance fracture in 1. The mean time between injury onset and the first MRI scan (Interval 1) was 10 hours (SD 8.7 hours), and the mean time to the second MRI scan (Interval 2) was 60 hours (SD 29.6 hours). The mean IML lengths of the first and second MR images were 38.8 mm (SD 20.4 mm) and 51 mm (SD 36.5 mm), respectively. The mean time from the first to the second MRI scan (Interval 3) was 49.9 hours (SD 28.4 hours), and the difference in IML lengths was 12.6 mm (SD 20.7 mm), reflecting an expansion rate of 366 \u03bcm\/ hour (SD 710 \u03bcm\/hour). IML expansion in patients with AIS Grades A and B was 918 \u03bcm\/hour (SD 828 \u03bcm\/hour), and for those with AIS Grades C and D, it was 21 \u03bcm\/hour (SD 304 \u03bcm\/hour). Univariate analysis indicated that AIS Grade A or B versus Grades C or D (p &lt; 0.0001), traction (p= 0.0005), injury morphology (p &lt; 0.005), the surgical approach (p= 0.009), vertebral artery injury (p= 0.02), age (p &lt; 0.05), ISS (p &lt; 0.05), ASIA motor score (p &lt; 0.05), and time to decompression (p &lt; 0.05) were all predictors of lesion expansion. In multiple regression analysis, however, the sole determinant of IML expansion was AIS grade (p &lt; 0.005).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>After traumatic subaxial cervical spine or spinal cord injury, patients with motor-complete injury (AIS Grade A or B) had a significantly higher rate of IML expansion than those with motor-incomplete injury (AIS Grade C or D).<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.spine14576","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T15:01:03Z","timestamp":1425654063000},"page":"611-621","source":"Crossref","is-referenced-by-count":51,"title":["Predictors of intramedullary lesion expansion rate on MR images of patients with subaxial spinal cord injury"],"prefix":"10.3171","volume":"22","author":[{"given":"Elizabeth","family":"Le","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bizhan","family":"Aarabi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathirkamanthan","family":"Shanmuganathan","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; and"}],"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; and"}],"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; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noori","family":"Akhtar-Danesh","sequence":"additional","affiliation":[{"name":"School of Nursing and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14576","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"122","DOI":"10.3171\/2010.9.SPINE09922","article-title":"Predictors of outcome in acute traumatic central cord syndrome due to spinal stenosis","volume":"14","author":"Aarabi","year":"2011"},{"key":"b2-spine14576","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"243","DOI":"10.3171\/2012.6.SPINE12122","article-title":"Intramedullary lesion expansion on magnetic resonance imaging in patients with motor complete cervical spinal cord injury","volume":"17","author":"Aarabi","year":"2012"},{"key":"b3-spine14576","series-title":"J Neurotrauma","doi-asserted-by":"publisher","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"},{"key":"b4-spine14576","series-title":"Advanced Trauma Life Support (ATLS) Program for Physicians","author":"Alexander","year":"1993"},{"key":"b5-spine14576","series-title":"J Nerve Ment Dis","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/00005053-191403000-00002","article-title":"Remarks on the histopathological changes in the spinal cord due to impact. 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