Noncompressive Myelopathy: An Imaging Review

Noncompressive myelopathies are intrinsic diseases of the spinal cord leading to neurologic dysfunction. Unlike compressive myelopathies, which are typically not a diagnostic dilemma and are managed operatively, noncompressive myelopathies can be more challenging to diagnose, and treatment addresses the specific underlying or precipitating condition. The cornerstones of diagnosis include the history and physical examination as well as paraclinical tests including laboratory analysis and MRI. Thus, radiologists play an important role in the timely and accurate diagnosis of noncompressive myelopathy. The purpose of this review is to describe the MRI findings of the most common causes of noncompressive myelopathy. Mimics and interpretation pearls will also be presented to further emphasize diagnostic accuracy.Learning Objective: To describe the broad differential diagnosis for noncompressive myelopathy and recognize key clinical and imaging features of each entity.