A Study on Etiological Profile of Non-Compressive Myelopathies in a Tertiary Care Hospital in Central Tamilnadu

ABSTRACT

Introduction: Non compressive myelopathy is defined as“spinal cord dysfunction in the absence of clinico-radiologicalevidence of spinal cord compression.” It can result fromdemyelinating, infectious, autoimmune, vascular, degenerativeand metabolic disorders in the absence of demonstrablecompression by imaging techniques. We aimed in analyzingthe etiological profile of non-compressive myelopathies in atertiary care hospital of Central Tamil nadu.Material and Methods: In the Neurology department, weconducted an observational study at Thanjavur MedicalCollege, Thanjavur, from September 2017 to September2018. Patients of non-compressive myelopathies whounderwent magnetic resonance imaging (MRI) of the spinewere segregated into two categories Degenerative and nonDegenerative, as well as into acute, subacute and chronicmyelopathies.Results: The study had 75 patients with a median age of34.5 years and male female ratio of 1.351. Presentation wasacute in 10 patients (13%), subacute in 5 (6.5%), chronic in54 (72.5%) and history of relapse and remission in 6(8%)patients. Degenerative etiology was found for 42 (56%)others were non degenerative (demyelinating, autoimmune,vascular, nutritional, or physical agent). MRI study carried outin all cases showed signal changes in 51 cases (68%) whichincluded myelomalacia, demyelination, atrophy of cord,infarction of cord. Etiological diagnosis could be establishedin 74 (97.3%) cases.Conclusion: Underlying etiology (degenerative,demyelinating, autoimmune, infectious, vascular, metabolicdisorder, or physical agent) was found in 91.3% patients ofnoncompressive myelopathy. Clinical features combinedwith MRI findings are helpful in defining the cause ofnon-compressive myelopathies. A follow-up of long termmay reveal some of the diagnosis especially degenerativemyelopathies in early stage.