Spinal Cord Compressive Myelopathy: Radiological Evaluation Using Magnetic Resonance Imaging in a Tertiary Care Center
Authors/Creators
- 1. Assistant Professor, Department of Radiodiagnosis, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kerala, India
- 2. Junior Resident, Department of Radiodiagnosis, Medical Trust Hospital, Ernakulam, Kerala, India
- 3. Professor and Head, Department of Radiodiagnosis, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kerala, India
Description
Background: Compressive myelopathy is the term used to describe spinal cord compression from different causes. This can be caused by etiologies either from outside or within the cord. The aim of the study is to determine the various causes of compressive myelopathy and their MRI characteristics. Methods: A prospective hospital-based study was conducted. Total of 30 cases were analysed over a period of from January 2020 to January 2022 and were investigated with MRI. Results: MRI is the modality of choice to image spine and spinal cord pathologies because of its ability to delineate soft tissue anatomy in multiple planes without ionizing radiation and non –invasiveness. Most common cause for compressive myelopathy in our study was spinal trauma (46.6%)> Metastasis (20%) > Infection/TB (16.7%) = Primary neoplasm (16.7%). Most of spinal injuries (most common), infections and secondary neoplasms involve extradural compartment while most of primary neoplasm involves intradural compartment. The common site involved is the cervical (50%) followed by thoracic (37.5%) Regions in cases of spinal injury. Conclusions: MRI is a very definitive, sensitive, accurate, specific, and non-invasive modality for evaluation of spinal cord myelopathy.
Abstract (English)
Background: Compressive myelopathy is the term used to describe spinal cord compression from different causes. This can be caused by etiologies either from outside or within the cord. The aim of the study is to determine the various causes of compressive myelopathy and their MRI characteristics. Methods: A prospective hospital-based study was conducted. Total of 30 cases were analysed over a period of from January 2020 to January 2022 and were investigated with MRI. Results: MRI is the modality of choice to image spine and spinal cord pathologies because of its ability to delineate soft tissue anatomy in multiple planes without ionizing radiation and non –invasiveness. Most common cause for compressive myelopathy in our study was spinal trauma (46.6%)> Metastasis (20%) > Infection/TB (16.7%) = Primary neoplasm (16.7%). Most of spinal injuries (most common), infections and secondary neoplasms involve extradural compartment while most of primary neoplasm involves intradural compartment. The common site involved is the cervical (50%) followed by thoracic (37.5%) Regions in cases of spinal injury. Conclusions: MRI is a very definitive, sensitive, accurate, specific, and non-invasive modality for evaluation of spinal cord myelopathy.
Files
IJTPR,Vol13,Issue8,Article19.pdf
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Additional details
Dates
- Accepted
-
2023-07-26
Software
References
- 1. Choi KH, Lee KS, Chung SO, et al. Idiopathic transverse myelitis: MR characteristics. AJNR Am J Neuroradiol. 1996; 17(6):1151-1160. 2. Chen CJ, Lyu RK, Lee ST, et al. Intramedullary high signal intensity on T2- weighted MR images in cervical spondylotic myelopathy: prediction of prognosis with type of intensity. Radiology. 2001; 221(3):789-794. 3. Fernandez de Rota JJ, Meschian S, Fernandez de Rota A, et al. Cervical spondylotic myelopathy due to chronic compression: the role of signal intensity changes in magnetic resonance images. J Neurosurg Spine. 2007; 6(1):17-22. 4. deSeze J, Lanctin C, Lebrun C, et al. Idiopathic acute transverse myelitis: application of the recent diagnostic criteria. Neurology. 2005; 65(12):1950-1953. 5. Kumar N. Pearls: myelopathy. Semin Neurol. 2010; 30(1):38-43. 6. Kulkarni MV, McArdle CB, Kopanicky D, Miner M, Cotler HB, Lee KF, et al. Acute spinal cord injury: MR imaging at 1.5 T. Radiology.1987;164:837–43. 7. Parizel PM, Gielen JL, Vanhoenacker FM. The spine in sports injuries: the cervical spine. In: Vanhoenacker FM, Maes M, Gielen JL (eds) Imaging of orthopedic sports injuries. Springer, Berlin, 2007; 377–390. 8. Hackney D. B., Asato R., Joseph P. M., Carvlin M. J., McGrath J. T., Grossman R. I., et al. Hemorrhage and edema in acute spinalcord compression: demonstration by MR imaging. Radiology. 1986; 161:387– 390 9. Ramon S, Domínguez R, Ramírez L, Paraira M, Olona M, Castelló T et al. Clinical and magnetic resonance imaging correlation in acute spinal cord injury. Spinal Cord. 1997; 35: 664–673. 10. Flanders FD. Enhanced MR Imaging of hypertrophic pachymeningitis: AmJ Roentgenol. 1997; 169: 1425-1428. 11. Yamashita Y, Takahashi M, Matsuno Y, Kojima R, Sakamoto Y, OguniT, etal. Acute Spinal cord Injury. Magnetic resonance Imaging correlated with myelopahty: The British Journal of Radiology. 1991; 64:201- 209. 12. Lien HH, Blomlie V, Heimdal K. Magnetic Resource Imaging of malignant extradural tumors with acute spinal cord compression: Acta Radiologica. 1990; 31:187-190. 13. Livingston KE, Perrin RG. The Neurosurgical management of spinalmetastases causing cord and cauda equine compression: J. Neurosurg. 1978; 49: 590- 594. 14. Dorsi MJ, Belzberg AJ. Paraspinalnerve Shealth tumors: Neurosurg Clin NAm. 2004; 15: 217-222. 15. Matsumoto S, Hasuo K, Uchino A, Mizushima A, Kawa TF, Matsuura Y, etal. MRI of Intradural Extramedullary Spinal neurinomas and meningiomas: Clinical Imaging. 1993; 17:46-52 16. Gezen F, Kahraman S, Canakci Z, Beduk A Review of 36 cases of Spinalcord Meningioma: Spine. 2000; 25: 727-731. 17. Souweidane MM, Benjamin V. Spinal Cord Meningiomas: Neurosurgery Clinics of North America. 1994; 5: 283-291. 18. Nabors MW et al. Updated assessment and current classification of spinalmeningeal cysts. J Neurosurg. 1988; 68: 366–377. 19. Rohrer DC, Burchiel KJ, Gruber DP. Intraspinal extradural meningeal cyst demonstrating ball-valve mechanism of formation. J Neurosurg. 1993; 78: 122–125 20. Numaguchi Y, Rigamonti D, Rothman MI. Spinal epidural abscess. Evaluation with Gd enhanced MR Imaging: Radiographics. 1993; 13:545. 21. Roos DEA, Persijn V, Meerten EL, Bloem JI. MRI of Tubercular spondylitis: AJR. 1986; 146: 79-82.