Prognostic Utility of BASIC Score and Intramedullary Lesion Length in Late-Presenting Cervical Spinal Cord Injury: A Retrospective Study
Abstract
Introduction: This study aimed to assess the association of Magnetic Resonance Imaging (MRI) parameters, such as the Brain and Spinal Injury Centre (BASIC) Score and Intramedullary Lesion Length (IMLL) with neurological improvement after surgery in late-presenting cervical spinal cord injury (SCI).
Materials and methods: We retrospectively reviewed 52 patients with traumatic cervical SCI who underwent decompression and stabilisation more than 36 hours after injury. Neurological improvement was defined as at least one-grade increase in the ASIA Impairment Scale (AIS) at 6 months. MRI scans were evaluated using the BASIC Score and IMLL. Logistic regression and ROC analysis were performed.
Results: Of 52 patients, 26 (50%) demonstrated neurological improvement. A mild BASIC Score (0–2) was significantly associated with improvement (OR 6.107, 95% CI 1.836 – 20.315, p=0.002). IMLL <30mm was also associated with better outcomes (OR 3.167, 95% CI 0.993 – 10.101, p=0.008). Multivariate analysis confirmed the BASIC Score as an independent predictor (p=0.008). Interobserver agreement for MRI readings was substantial (kappa = 0.72).
Conclusion: In late-presenting cervical SCI, the BASIC Score and IMLL are associated with neurological improvement after surgery. MRI parameters may aid in early prognosis and patient counselling.
Abstract | Reference
