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

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.