Objective: To determine the utility of MR imaging in the assessment of spinal cord injury following penetrating spinal trauma.
Methods: We retrospectively reviewed the case notes and MR studies of patients referred to our MR facility over a 2-year period with neurological deficits following penetrating spinal injuries. All MR studies were performed on the same MR scanner with identical protocols. We reviewed the MR studies blinded to the clinical data and MR reports. We recorded the presence of: spinal cord transection, cord contusion, haematomyelia, extramedullary haematoma and vascula injury.
Results: 20 patients (17 males, 3 females) with a mean age of 28 years were studied. Causes of injury were knife wounds in 17 patients and gun shot wounds in 3 patients. Site of injury was: cervical in 14, thoracic 4, lumbar in 2. Neurological deficits were: Brown-Séquard syndrome in 8, paraparesis in 7, quadraparesis in 2, hemiplegia 2, unconscious 1. MR findings were: partial cord transection in 9 patients, cord oedema/contusion in 5, haematomyelia in 2, myelomalacia in 2, and disk herniation in 1. One patient with cord transection sustained verterbral artery occlusion. Only 4 patients with Brown-Séquardsyndrome had partial cord transection, the other 5 had cord contusions.
Conclusions: MR accurately demonstrates spinal cord injury in patients with penetrating spinal trauma, however the clinical signs detected do not always correlate with the MR findings.

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