Combined predictive value of MRI parameters and inflammatory biomarkers in assessing the severity and prognosis of acute cervical traumatic

Abstract Objective This study evaluated the combined predictive value of preoperative MRI variables and preoperative peripheral inflammatory biomarkers in assessing the severity and prognosis of acute cervical TSCI. Methods MRI parameters and peripheral inflammatory biomarkers were analyzed to determine their correlation with initial injury severity and 1-year follow-up prognosis. The predictive performance of different combinations of MRI variables and biomarkers was assessed using ROC analysis. Results A total of 232 patients with acute cervical TSCI were included. MRI variables (including IMLL [intramedullary lesion length], BASIC [Brain and Spinal Cord Injury Center] score, MSCC [maximum spinal cord compression], MCC [maximum canal compromise], and sagittal grade system) and inflammatory biomarkers (including white blood cell [WBC] count, neutrophil count, platelet count, lymphocyte count, monocyte count, CRP [C-reactive protein], and novel inflammatory biomarkers (NLR[Neutrophil-to-lymphocyte ratio], PLR [Platelet-to-lymphocyte ratio], LMR [Lymphocyte-to-monocyte ratio] and SII [Systemic immune inflammatory index]) were significantly associated with initial injury severity. Univariate and multivariate logistic regression analyses identified BASIC score, severity of injury, SII, and NLR as independent predictors of poor prognosis. Notably, a model incorporating severity of injury, BASIC score, NLR, and SII demonstrated the highest predictive accuracy, yielding a superior area under the curve (AUC). Conclusions The combination of the preoperative BASIC score, NLR, SII, and injury severity may serve as an exploratory preoperative prognostic model for neurological recovery after TSCI.