PATTERN RECOGNITION ,APPROACH AND CLINICO-RADIOLOGIC EVALUATION OF MYELOPATHIES

Abstract

INTRODUCTION Myelopathy, the rapid or insidious onset of motor and sensory abnormalities referable to the spinal cord, occurs as a result of a variety of causes that may be classied on the basis of their location of origin (intramedullary, intradural-extramedullary, and extradural). Osteophytic spurring and disc herniation may also produce myelopathy localised to the thoracic spine, though less commonly. Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. AIM OF THE STUDY: 1. To study the clinical prole of cases of Myelopathy 2. To study the pattern of spinal cord involvement 3. To compare the clinical diagnosis with MRI diagnosis MATERIALS AND METHODS Ÿ Study setting: The study was conducted on patients admitted in the departments of neurology and neurosurgery with clinical suspicion of spinal cord disease Ÿ Study design: The current study was a prospective stud Ÿ Study period: The study was conducted between august 2021 to July 2022 Ÿ Sample size: The present prospective study included 30 patients admitted in the departments of neurology and neurosurgery with clinical suspicion of spinal cord disease. INCLUSION CRITERIA: Inclusion criteria include patients with clinical suspicion of spinal cord disease of age group 20-80 years were included as study participants in the present study. EXCLUSION CRITERIA: The current study excluded patients with seizures, abnormal higher mental functions, and children. RESULTS Ÿ In the present series, the patient's age ranged from 20 years to 80 years Ÿ The majority of 53.33% of participants were aged between 51 to 60 years, followed by 61 to 70 years was 13.33%, 21 to 30 years and 41 to 50 was 10% for each Ÿ Distribution of cases according to etiology: Among the study population, 17 (57%) participants had cervical spondylosis, 4 (13%) participants had caries spine, 3 (10%) participants had a vertebral fracture and others for each, 2 (7%) participants had uorosis and only 1 (3%) participant had spinal tumor Ÿ Clinico-radiological patterns of spinal cord syndromes: The majority of 50% of participants had Anterior + Posterior Cord involvement. The proportion of posterior cord, pan cord, and the central cord was 20%, 13.33%, and 10% respectively CONCLUSION: Ÿ The present study results have analyzed the prole of myelopathies and found more male preponderance Ÿ The commonest cause of compressive myelopathy was Cervical spondylosis Ÿ Anterior plus posterior cord syndrome was the commonest pattern seen which was followed by posterior cord syndrome and the least observed pattern was anterior cord syndrome. Hence, it can be concluded that MRI could suggest the location of the lesion and correlated well with clinical diagnosis.