Spinal cord transection, as the name implies, refers to a tear within the spinal cord as a result of a significant traumatic injury. It is an important radiological finding that can influence the decision on potential surgery in the setting of spinal trauma.
The presentation is almost always in the context of significant trauma and clinical features usually involve motor and sensory neurology corresponding to the level of cord injury.
Characteristically there is:
- lower motor neuron paralysis at the level of injury
- upper motor neuron (or spastic) paralysis below the level of injury
The degree of neurological compromise corresponds with the degree of cord transection. In partial transection, there may still be some retained sensory-motor function while in complete transection there is a complete loss of function.
MRI is the investigation of choice and is often performed acutely in the context of recent traumatic spinal injury that may or may not be confirmed by trauma CT.
Treatment and prognosis
The role of acute MRI is usually to assess for the presence of treatable acute pathologies such as an epidural hematoma or cord compression, which can be targeted by surgical decompression. The identification of significant cord transection can potentially contraindicate surgery.