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The presence or absence of midsagittal tissue bridges and walking: a retrospective cohort study in spinal cord injury

Spinal Cord volume 61, pages 436–440 (2023)Cite this article

Subjects

Abstract

Study design

Cohort study. Retrospective analysis of T2-weighted magnetic resonance images (MRIs) and clinical documentation.

Objectives

To evaluate the relationship between the presence/absence and widths of midsagittal tissue bridges and walking ability among veterans with cervical, predominantly chronic SCI.

Setting

University research and hospital setting.

Methods

T2-weighted midsagittal MRIs of 22 United States veterans with cervical spinal cord injuries were examined. The presence/absence of midsagittal tissue bridges were determined, and the widths of present ventral and dorsal tissue bridges were measured. Midsagittal tissue bridge characteristics were related to each participant’s ability to walk based off examination of clinical documentation.

Results

Fourteen of the analyzed participant images revealed the presence of midsagittal tissue bridges. Ten of those individuals (71%) possessed overground walking ability. The 8 individuals with no apparent tissue bridges were all unable to walk. There was a significant correlation between walking and widths of ventral midsagittal tissue bridges (r = 0.69, 95%CI: 0.52, 0.92, p < 0.001), as well as dorsal midsagittal tissue bridges (r = 0.44, 95%CI: 0.15, 0.73, p = 0.039).

Conclusion

The evaluation of midsagittal tissue bridges may be useful in various rehabilitation settings to help inform patients’ plan of care, allocation of neuromodulatory resources, and appropriate stratification into research cohorts.

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Fig. 1: Examples of the presence and absence of midsagittal tissue bridges using the midsagittal T2 weighted scan of the cervical spine.

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Data availability

Additional data are available from the corresponding author on reasonable request.

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Funding

ACS was supported by NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development – K01HD106928. WAT and ACS were supported by the Boettcher Foundation’s Webb-Waring Biomedical Research Program.

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Authors and Affiliations

  1. University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO, USA

    W. A. Thornton, K. Rasheed & A. C. Smith

  2. Rocky Mountain Regional VA Medical Center Spinal Cord Injury & Disorders Center, Aurora, CO, USA

    G. Marzloff, S. Ryder, A. Best & D. Coons

Authors
  1. W. A. Thornton
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  2. G. Marzloff
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  3. S. Ryder
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  4. A. Best
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  5. K. Rasheed
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  6. D. Coons
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  7. A. C. Smith
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Contributions

WAT was responsible for designing the study, assessing the imaging, analyzing imaging data, interpreting the results, and writing the report. GM was responsible for providing access to the images and determining walking ability of the participants. He also contributed to providing participant demographic information and provided feedback on the report. SR was responsible for providing access to the images and determining walking ability of the participants. She also contributed to providing participant demographic information and provided feedback on the report. AB was responsible for providing access to the images and provided feedback on the report. KR was responsible for assisting with the reliability testing for imaging measurements. She also provided feedback on the report. DC provided approval for project collaboration, access to the images, and contributed to determining walking ability of the participants. ACS was responsible for providing funding for the project and training in imaging measurements. He also contributed with collecting images for assessment, data analysis and interpretation, and providing feedback on the report.

Corresponding author

Correspondence to W. A. Thornton.

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Competing interests

The authors declare no competing interests.

Ethical approval

The research described in our manuscript was in compliance with the Declaration of Helsinki and approved by COMIRB, the Colorado Multiple Institutional Review Board.

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Thornton, W.A., Marzloff, G., Ryder, S. et al. The presence or absence of midsagittal tissue bridges and walking: a retrospective cohort study in spinal cord injury. Spinal Cord 61, 436–440 (2023). https://doi.org/10.1038/s41393-023-00890-6

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