In a breakthrough longitudinal study, researchers have identified the crucial value of neuroimaging measures derived from clinical magnetic resonance imaging (MRI) scans for prediction of sensory and motor recovery in people with acute cervical spinal cord injury (SCI).
Published in world-renowned medical journal The Lancet Neurology, the study underscores the potential of preserved spinal tissue bridges—adjacent neural tissue spared from injury—to predict sensorimotor recovery.

Prognostication of recovery after spinal cord injury (SCI) is lacking accuracy despite its importance for people being directly affected and their environment, the research team says. The team, which included first author Dr. Dario Pfyffer, senior author Dr. Patrick Freund, and international SCI experts successfully established models incorporating spinal tissue bridges for improved prognostication of clinical outcomes in a large multicentric cohort of cervical SCI patients. The study involved 227 patients with acute cervical SCI, tracked from admission through to 12 months post-injury.
Measured on MRI images assessed early after SCI, these tissue bridges added crucial value to prognostic models that include information of the patients’ clinical status at hospital admission. “Accurate outcome prediction is of utmost importance for patients, treating therapists, and attending doctors,” says Stanford’s Dr. Dario Pfyffer.

By investigating recovery at hospital discharge at around 3 months after the injury and at 12 months follow-up, this landmark imaging study provides compelling evidence that spinal tissue bridges are associated with short-term and long-term clinical improvement.
Remarkably, tissue bridges have also been found to be more powerful and accurate predictors than baseline clinical measures for categorizing patients into subgroups with similar clinical outcomes across all three international centers. Stratification of a heterogeneous patient cohort into more homogeneous subgroups of distinct recovery profiles is of utmost importance when aiming to differentiate between spontaneous recovery and recovery due to an intervention in clinical trials.
Recovery prediction models need to be reproducible and generalizable to new patients, Pfyffer asserts. The study results were validated across individual SCI patient cohorts from the three centers despite their demographic and clinical differences.
This detail lays the foundation for a successful application of tissue bridges for improved conduction of multicentre interventional trials. Further, the relationships between neuroimaging-derived tissue bridges and both 3 months and 12 months outcomes highlight the broad clinical applicability of the study’s approach.
The study’s findings have the potential to change clinical practice, paving the way for more targeted therapeutic approaches in spinal cord injury management. As efforts continue to improve prognostic accuracy, emphasis on optimizing recovery trajectories and enhancing patient care are paramount.
Media Contact
Dario Pfyffer, PhD
dpfyffer@stanford.edu
Tel 650-723-0727