Michael G. Fehlings, Toronto Western Hospital; University of Toronto
Allan R. Martin, Toronto Western Hospital
Lindsay A. Tetreault, Toronto Western Hospital; University College Cork
Bizhan Aarabi, University of Maryland at Baltimore
Paul Anderson, University of Wisconsin, Madison
Paul M. Arnold, The University of Kansas
Darrel Brodke, University of Utah
Anthony S. Burns, Toronto Rehabilitation Institute
Kazuhiro Chiba, National Defense Medical College
Joseph R. Dettori, Spectrum Research, Inc
Julio C. Furlan, University of Toronto; Toronto Rehabilitation Institute
Gregory Hawryluk, University of Utah
Langston T. Holly, University of California at Los Angeles
Susan Howley, Christopher & Dana Reeve Foundation
Tara Jeji, Ontario Neurotrauma Foundation
Sukhvinder Kalsi-Ryan, Toronto Western Hospital
Mark Kotter, University of Cambridge
Shekar Kurpad, Medical College of Wisconsin
Brian K. Kwon, University of British Columbia
Ralph J. Marino, Thomas Jefferson UniversityFollow
Eric Massicotte, Toronto Western Hospital
Geno J. Merli, Thomas Jefferson UniversityFollow
James W. Middleton, University of Sydney
Hiroaki Nakashima, Nagoya University
Narihito Nagoshi, Toronto Western Hospital; Keio University
Katherine Palmieri, The University of Kansas
Anoushka Singh, Toronto Western Hospital
Andrea C. Skelly, Spectrum Research, Inc
Eve C. Tsai, Ottawa Hospital Research Institute
Alexander R. Vaccaro, Thomas Jefferson UniversityFollow
Jefferson R. Wilson, University of Toronto; St. Michael’s Hospital
Albert Yee, Sunnybrook Health Sciences Centre
James Harrop, Thomas Jefferson UniversityFollow

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Publication Date



This article has been peer reviewed. It is the author’s final published version in Global Spine Journal

Volume 7, Issue 3 Supplement, September 2017, Pages 221S-230S.

The published version is available at DOI: 10.1177/2192568217703089. Copyright © Fehlings et al.


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. © 2017, © The Author(s) 2017.

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