Abnormal stretch and strain is a major cause of injury to the spinal cord and brainstem. Such forces can develop from
age-related degeneration, congenital malformations, occupational exposure, or trauma such as sporting accidents,
whiplash and blast injury. While current imaging technologies provide excellent morphology and anatomy of the spinal
cord, there is no validated diagnostic tool to assess mechanical stresses exerted upon the spinal cord and brainstem.
Furthermore, there is no current means to correlate these stress patterns with known spinal cord injuries and other
clinical metrics such as neurological impairment. We have therefore developed the spinal cord stress injury assessment
(SCOSIA) system, which uses imaging and finite element analysis to predict stretch injury. This system was tested on a
small cohort of neurosurgery patients. Initial results show that the calculated stress values decreased following surgery,
and that this decrease was accompanied by a significant decrease in neurological symptoms. Regression analysis
identified modest correlations between stress values and clinical metrics. The strongest correlations were seen with the
Brainstem Disability Index (BDI) and the Karnofsky Performance Score (KPS), whereas the weakest correlations were
seen with the American Spinal Injury Association (ASIA) scale. SCOSIA therefore shows encouraging initial results
and may have wide applicability to trauma and degenerative disease involving the spinal cord and brainstem.