Abstract

Background: Myelopathy is a disabling disease, which not only affect the motor, sensory &autonomic functions, but also have serious psychosocial sequelae. This study aims at assessment of the clinical features of patients suffering from non-traumatic myelopathy in a tertiary care centre and also to study whether the clinical localization correlates with the radiological findings.

Objectives: To study the clinical and radiological profile of patients admitted with non-traumatic myelopathy in Government Medical college hospital, Thiruvananthapuram, Kerala.  To estimate the prevalence of compressive and non-compressive aetiology in patients admitted with non-traumatic myelopathy in medical wards. To study the agreement between clinical spinal segmental level estimate and radiological findings.

Materials and Methods: This is a hospital based descriptive study on patients admitted with quadriplegia or paraplegia. The details of patients including demographics, symptoms and signs, etiology and radiological diagnosis were using pretested structured data sheet.

Results: A total of 64 patients were studied of which 37 (57.8% )were male and 27(42.2%) were females. 36 patients (56.3%) presented with clinical features of acute myelopathy, 8 patients (12.5%) had sub-acute presentation and 20 (31.3%) had chronic history of symptoms. 13 (20.3%) patients had quadriparesis and 51 (79.7%)patients had paraplegia. 32 (50%) had compressive myelopathy and 32 (50%) had non compressive myelopathy The most common cause of Compressive myelopathy in our study was Tuberculosis of spine (34.3% among compressive myelopathy) followed by cervical spondylitis (31.2%) and metastasis(6). Out of 11 patients with tuberculosis of spine, in seven patients the spinal segment level diagnosed clinically were within ± 1 spinal segment in MRI and in 4 patients within ± 2segments in MRI. The most common cause of non-compressive myelopathy inour study was Transverse Myelitis (24 cases among 32 cases of non compressive myelopathy) (75%). Only in 6 patients (18.75%), spinal segment level diagnosed clinically corresponded to spinal level in MRI of spine.

Conclusion: Tuberculosis of the spine is the most common cause of compressive myelopathy and Transverse Myelitis is the most common non compressive myelopathy in this study. The clinical spinal segment estimate and radiological spinal segment level has more agreement in compressive myelopathy than non-compressive myelopathy. Magnetic resonance imaging is an essential tool in the diagnosis of myelopathy.

Keywords: Compressive myelopathy, Non-compressive myelopathy.