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2017 ; 7
(3 Suppl
): 221S-230S
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
A Clinical Practice Guideline for the Management of Patients With Acute Spinal
Cord Injury: Recommendations on the Role of Baseline Magnetic Resonance Imaging
in Clinical Decision Making and Outcome Prediction
#MMPMID29164028
Fehlings MG
; Martin AR
; Tetreault LA
; Aarabi B
; Anderson P
; Arnold PM
; Brodke D
; Burns AS
; Chiba K
; Dettori JR
; Furlan JC
; Hawryluk G
; Holly LT
; Howley S
; Jeji T
; Kalsi-Ryan S
; Kotter M
; Kurpad S
; Kwon BK
; Marino RJ
; Massicotte E
; Merli G
; Middleton JW
; Nakashima H
; Nagoshi N
; Palmieri K
; Singh A
; Skelly AC
; Tsai EC
; Vaccaro A
; Wilson JR
; Yee A
; Harrop JS
Global Spine J
2017[Sep]; 7
(3 Suppl
): 221S-230S
PMID29164028
show ga
INTRODUCTION: The objective of this guideline is to outline the role of magnetic
resonance imaging (MRI) in clinical decision making and outcome prediction in
patients with traumatic spinal cord injury (SCI). METHODS: A systematic review of
the literature was conducted to address key questions related to the use of MRI
in patients with traumatic SCI. This review focused on longitudinal studies that
controlled for baseline neurologic status. A multidisciplinary Guideline
Development Group (GDG) used this information, their clinical expertise, and
patient input to develop recommendations on the use of MRI for SCI patients.
Based on GRADE (Grading of Recommendation, Assessment, Development and
Evaluation), a strong recommendation is worded as "we recommend," whereas a
weaker recommendation is indicated by "we suggest." RESULTS: Based on the limited
available evidence and the clinical expertise of the GDG, our recommendations
were: (1) "We suggest that MRI be performed in adult patients with acute SCI
prior to surgical intervention, when feasible, to facilitate improved clinical
decision-making" (quality of evidence, very low) and (2) "We suggest that MRI
should be performed in adult patients in the acute period following SCI, before
or after surgical intervention, to improve prediction of neurologic outcome"
(quality of evidence, low). CONCLUSIONS: These guidelines should be implemented
into clinical practice to improve outcomes and prognostication for patients with
SCI.