Clinicoradiological Correlation Between Descending Spinal Cord Tract Integrity and Functional Motor Recovery Following Traumatic Cervical Spinal Cord Injury: A Prospective Observational Study
- Jul 10
- 2 min read
Original Research | 2026 | Volume 2 | Issue 1 | Page 55-68
Dr. Debadulal Das Bidhar, Assistant Professor, Dept. Of Neurosurgery, Cdsimer, Devarakaggalahalli, Harohalli, Kanakapura Main Road, Kanakapura, Karnataka 562112, Mail Id Drddbidharneuro@Gmail.Com
Dr Neeraj Sharma, MBBS, M.Ch., DrNB, Associate Professor, Department Of Neurosurgery, Heritage IMS, Varanasi
Dr. Akash P Oza, Senior Resident, Department Of Neurosurgery, Gcs Medical College, Ahmedabad. Email: Akashoza45@Gmail.Com
Corresponding Author:-
Dr. Akash P Oza, Senior Resident,
Department Of Neurosurgery,
GCS Medical College, Ahmedabad.
Email: Akashoza45@Gmail.Com
Abstract
Background: Traumatic cervical spinal cord injury (TCSCI) is a devastating neurological condition associated with substantial motor disability and long-term functional impairment. The extent of damage to descending spinal cord tracts, particularly the corticospinal tract, reticulospinal tract, and rubrospinal tract, plays a crucial role in determining motor recovery. Advances in magnetic resonance imaging (MRI) have enabled detailed assessment of spinal cord tract integrity, facilitating clinicoradiological correlation with neurological outcomes. However, prospective data examining the relationship between tract preservation and functional recovery remain limited.
Objective: To evaluate the association between radiological integrity of descending spinal cord tracts and functional motor recovery in patients with traumatic cervical spinal cord injury over a six-month follow-up period.
Methods: This prospective observational study enrolled 80 patients aged 18–65 years with acute traumatic cervical spinal cord injury presenting within 72 hours of injury. Clinical assessments included the American Spinal Injury Association (ASIA) Impairment Scale, ASIA Motor Score (AMS), Modified Barthel Index (MBI), and Spinal Cord Independence Measure (SCIM). MRI of the cervical spine, including diffusion tensor imaging (DTI), was performed to evaluate lesion characteristics, corticospinal tract continuity, fractional anisotropy (FA), and apparent diffusion coefficient (ADC). Patients received standard medical and rehabilitative care and were followed at 1, 3, and 6 months. Clinicoradiological correlations were analyzed using Pearson's correlation and multivariable regression.
Results: Patients demonstrating preserved descending tract integrity exhibited significantly greater improvements in ASIA Motor Scores and SCIM scores compared with those showing severe tract disruption (p < 0.001). Higher baseline FA values positively correlated with motor recovery (r = 0.68, p < 0.001), whereas increased ADC values were associated with poorer neurological outcomes (r = –0.54, p < 0.001). MRI evidence of limited intramedullary hemorrhage and shorter lesion length independently predicted superior functional recovery at six months.
Conclusion: Preservation of descending spinal cord tract integrity is strongly associated with improved neurological and functional recovery following traumatic cervical spinal cord injury. Advanced MRI and diffusion tensor imaging provide valuable prognostic biomarkers that complement clinical assessment, enabling more accurate prediction of recovery and supporting individualized rehabilitation planning. Future multicenter studies with larger cohorts are warranted to validate these imaging markers and optimize prognostic models for cervical spinal cord injury.
Keywords: Traumatic cervical spinal cord injury, descending spinal tracts, corticospinal tract, diffusion tensor imaging, magnetic resonance imaging, ASIA Impairment Scale, motor recovery, clinicoradiological correlation.