Tissue bridges as predictors of recovery from cervical spine injuries

Results of the Longitudinal Study,”Prognostic value of tissue bridges in cervical spinal cord injury”, have the potential to change clinical practice. They have been published in The Lancet Neurology.

The team led by lead author Dr. Dario Pfyffer and senior author Prof. Dr. med. Patrick Freund from Balgrist University Hospital and the University of Zurich, which includes SCI experts from around the world, has successfully developed models that integrate spinal cord tissue bridges in a large, multicenter cohort of patients with cervical spinal cord injury for a better prognosis of clinical outcomes.

These tissue bridges were measured on MRI images (taken shortly after the onset of the spinal cord injury). This has resulted in great added value for the previous prognosis models, which are based on recording the clinical condition of patients upon admission to hospital. Dr. Pfyffer said: “An accurate prediction of outcome is of paramount importance to patients, treating therapists and treating physicians.”

Remarkably, in all three rehabilitation centers, the tissue bridges also proved to be more performative and accurate predictors than the baseline clinical data for dividing patients into subgroups with similar clinical outcomes.

Dr. Pfyffer emphasizes the importance of models for predicting recovery being reproducible and generalizable to new patients. In particular, the study results were validated in the individual SCI patient cohorts of the three centers with their demographic and clinical differences.

“Our models and results are transferable to other patient cohorts and are valid for all spinal cord injury centers, MRI scanners and people who perform and evaluate the measurements.” This lays the foundation for successful application of tissue bridges for the improved implementation of multicenter intervention studies.

This groundbreaking imaging study examined recovery progress when the patient was discharged approximately three months after the injury and at 12-month follow-up. As a result, the study was able to provide compelling evidence that spinal cord tissue bridges are associated with short- and long-term clinical improvements, underscoring the broad clinical applicability of the research approach.

The study demonstrates the incredible potential of tissue bridges to optimize clinical decision making, patient management and planning of spinal cord injury studies if tissue bridges are routinely established as part of clinical standards of care. The study is also a further step in the development of more specific rehabilitation programs and individualized treatment strategies for people with spinal cord injuries.

Patients in this multinational study were treated at Balgrist University Hospital, Zurich (Switzerland), BG Trauma Center, Murnau (Germany) and Craig Hospital, Denver (USA).