Evaluation of non-traumatic myelopathy using magnetic resonance imaging

Abstract

Background: Prompt and concise diagnosis of etiologic agent behind Non-Traumatic Myelopathy (NTM) and localization of the site of lesion are essential for prediction of neurological and functional outcomes. Magnetic Resonance Imaging (MRI) plays a key role in evaluation of myelopathy. Objectives: The objective of the present study was to characterize the spinal cord lesions in Non-traumatic Myelopathy and to evaluate the etiological factors leading to NTM. Materials and Methods: A hospital based cross-sectional study was done from November 2017 to May 2019 in a tertiary care centre of South India, where 85 patients with clinical suspicion of NTM were evaluated with MRI of spine. The MRI data collected was analyzed and described. Results: Out of 85 patients in our study group, 44 (51.8%) were males and 41 (48.2%) were females, without any significant gender predilection. The age group ranged from 5 to 83 years, with majority of patients in the 7th decade (25.9%). Degenerative myelopathy was the most common etiology accounting for 57.6% of the patients, followed by infective (28.2%), primary neoplastic (9.4%), congenital (1.1%), demyelinating (1.1%), metastatic (1.1%) and nutritional (1.1%) etiologies. Conclusion: MRI characteristics of the most common lesions were sufficiently distinct to allow them to be differentiated from each other and from most other entities. Other characteristics such as extradural versus intradural, intramedullary versus extramedullary, nature of enhancement on Post Gadolinium study, the presence of epidural, prevertebral and paravertebral involvement permit further differentiation among the various other abnormalities. MRI is a very sensitive, specific, non-invasive radiation-free modality for evaluation of NTM.