Role of Magnetic Resonance Imaging in the Evaluation of Compressive Myelopathy

Background: Compressive myelopathy is a common disease. Compressive myelopathy encompasses many pathological conditions that cause damage to the spinal cord or dysfunction of the spinal cord by compression either within the spinal cord or from the outside of the cord. Many of these spinal cord diseases have the potential to be reversible if recognised early and treated appropriately. Hence, the prognosis of this condition depends on a timely and accurate diagnosis. Magnetic resonance imaging (MRI) is essential when dealing with a multifactorial disorder, such as compressive myelopathy, which is considered one of the serious neurological emergencies. We attempted to evaluate the various causes of compressive myelopathy and to characterise them. Materials and Methods: This is a retrospective study conducted at a tertiary care hospital in Chennai from January 2024 to June 2024. We retrospectively examined a total of 48 cases from our department with the reports of compressive myelopathy on MRI spine studies. Results: We found that degenerative myelopathy (37.5%) was found to be the most common cause, followed by trauma (22.9%) and infection (18.8%), malignancy, including metastasis (16.7%), and Hirayama(4.2%). The cervical spine compression (54.2%) and the extradural compartment (89.6%) were more frequently involved. Conclusion: The study recommends MRI for individuals with suspected compressive myelopathy, as it accurately identifies the underlying cause and related characteristics. Providing precise information about the patient’s long-term prognosis is beneficial.