MRI as an imaging modality in evaluation of spinal pathologies causing Compressive Myelopathy

Author: Yuvabalakumaran G., Srikar B., Vinoth Kumar S. and Sidhesh R.M. and Anupritha S.

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Abstract

Quadriplegia and impairment are most commonly caused by spinal cord compression. Many spinal cord illnesses can be reversed if detected and treated early on, making them one of the most serious neurologic crises. MRI is used to differentiate between compressive and non-compressive causes of myelopathy. The goals of this study are to reliably locate a spinal tumour as Extradural / Intradural location, also to evaluate the spinal cord, intervertebral discs and ligament integrity following acute spinal trauma. MRI was performed on patients with a probable clinical history of compressive myelopathy in VMKV medical college, Salem. Purposive sampling was used to choose the patients for the study and descriptive analysis was used to evaluate the data. Spinal trauma (43.3 %) and spinal infection / TB (23.3 %) were the most common causes of spinal cord compression. Extradural compressive lesions accounted for 25 of the 30 cases, while Intradural – Extramedullary lesions accounted for 5. There were 13 cases of spinal damage, 7 cases of infective spondylitis with epidural component, one epidural abscess, and 5 metastases among the twenty-five extradural compressive pathology. 4 out of 5 intradural tumours were appropriately detected. So, MRI is the gold standard for evaluating soft tissue injuries in the spine, including spinal cord edema/contusion, intervertebral discs, and ligaments. Although MRI is most sensitive tool for detecting, characterising, and grading spinal infections, biopsy and culture are still required for a definitive diagnosis. So, at the conclusion, I can say that MRI is non-invasive, radiation free which is highly definitive, sensitive, and accurate modality for evaluating compressive myelopathy.

Keywords

Spine, compressive myelopathy, spinal trauma, extradural compression, intradural neoplasms, MRI

Conclusion

MRI is the gold standard for detecting abnormalities in the soft tissues of the spine and the spinal cord with good anatomical delineation. It is the most effective and the most sensitive method for determining cord edema in initial compression stages and cord contusions, also good to visualize the intervertebral discs, neural foramen and ligaments (mainly ALL & PLL) integrity. MRI is a highly sensitive imaging technique that is often used to detect and characterise spinal lesions and also infections. Biopsy and histological investigation are still used to make the final diagnosis. MRI is the only imaging technique that can directly view the spinal cord without any invasive procedure. In my research, we were able to classify the spinal masses / tumors depending on anatomical location into extradural or intradural compartment and analyse the full length of spinal cord at all the levels, IV discs and disc spaces, also the integrity of ligaments following acute spinal trauma using MRI. So, at the conclusion, I can say that MRI is a highly precise, sensitive, accurate and non-invasive modality for evaluating compressive myelopathy without using radiation.

References

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How to cite this article

Yuvabalakumaran G., Srikar B., Vinoth Kumar S., Sidhesh R.M. and Anupritha S. (2023). MRI as an imaging modality in evaluation of spinal pathologies causing Compressive Myelopathy. Biological Forum – An International Journal, 15(6): 291-296.