Compressive myelopathy

Changed by Mostafa Elfeky, 27 Sep 2022

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Disclosures - updated 11 May 2022: Nothing to disclose

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Compressive myelopathy refers to neurological deficits that result from compression of the spinal cord. It most commonly occurs in the cervical spinal cord.

Pathology

Any cause of spinal canal stenosis including disc herniation, osteophytes, spinal osteochondroma, extradural mass, and/or paravertebral ligamentous ossification ^1,2.

Radiographic features

MRI

Intramedullary T2 hyperintense signal in the setting of symptoms of acute cord compression is an urgent finding and probably indicates acute cord ~~edema~~oedema and ~~ischemia~~ischaemia ³.

These have been associated with worse outcomes: ³

high T2 signal intensity in a compressed segment relative to a non-compressed segment
low T1 signal intensity change with high T2 signal intensity at the compressed segment

-<p><strong>Compressive myelopathy </strong>refers to neurological deficits that result from compression of the <a href="/articles/spinal-cord">spinal cord</a>. It most commonly occurs in the cervical spinal cord. </p><h4>Pathology</h4><p>Any cause of <a title="Spinal canal stenosis" href="/articles/spinal-stenosis-1">spinal canal stenosis</a> including <a href="/articles/disc-herniation">disc herniation</a>, <a href="/articles/osteophyte-2">osteophytes</a>, <a title="spinal osteochondroma" href="/articles/spinal-osteochondroma">spinal osteochondroma</a>, <a title="Spinal extradural mass" href="/articles/spinal-epidural-mass">extradural mass</a>, and/or paravertebral ligamentous ossification <sup>1,2</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>Intramedullary T2 hyperintense signal in the setting of symptoms of acute cord compression is an urgent finding and probably indicates acute cord edema and ischemia <sup>3</sup>.</p><p>These have been associated with worse outcomes: <sup>3</sup></p><ul>
+<p><strong>Compressive myelopathy </strong>refers to neurological deficits that result from compression of the <a href="/articles/spinal-cord">spinal cord</a>. It most commonly occurs in the cervical spinal cord. </p><h4>Pathology</h4><p>Any cause of <a href="/articles/spinal-stenosis-1">spinal canal stenosis</a> including <a href="/articles/disc-herniation">disc herniation</a>, <a href="/articles/osteophyte-2">osteophytes</a>, <a href="/articles/spinal-osteochondroma">spinal osteochondroma</a>, <a href="/articles/spinal-epidural-mass">extradural mass</a>, and/or paravertebral ligamentous ossification <sup>1,2</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>Intramedullary T2 hyperintense signal in the setting of symptoms of acute cord compression is an urgent finding and probably indicates acute cord oedema and ischaemia <sup>3</sup>.</p><p>These have been associated with worse outcomes: <sup>3</sup></p><ul>

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Image 9 MRI (T2) ( create )

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