Magnetic Resonance Imaging-Based Evaluation of the Etiology of Non-Traumatic Myelopathies in Bangladesh: A Hospital-based Observational Cross-sectional Study from Two Tertiary Care Centers of Dhaka

Abstract

Background: Non-traumatic myelopathies has several etiologies. Objectives: The aim of the study was to see the etiology of non-traumatic myelopathy based on magnetic resonance imaging (MRI) changes in the context of Bangladesh. Methodology: Patients clinically diagnosed as non-traumatic myelopathy in the department of neurology of Sir Salimullah Medical College and Hospital (SSMCH), and in the inpatient wards of the National Institute of Neurosciences (NINS), considering the inclusion and exclusion criteria were enrolled as the study population from May 2014 to December 2015. Age, gender, clinical presentations and type of lesion based on MRI changes were collected. All the data were analyzed statistically. Results: Total 100 cases satisfied the inclusion and exclusion criteria in this study. Among them, there were 62 males and 38 females with a male to female ratio of 1.63:1. The mean age was found to be (mean ± SD) 45.80 ±15.28 with age ranges from 15 to 74 years. The highest number of patients (26.0%) was in the age group 51-60 years, followed by 24% patients in the age group 31-40 years. Based on MRI scan, most common etiologies that commonly diagnosed are cervical spondylotic myelopathy (31%), transverse myelitis (26%), primary spinal tumour (13%), spinal tuberculosis(12%), spinal metastatic disease (12%), and unclassified (6%). MRI scan also detect the common sites of involvements of these causes. Conclusion: In this study cervical spondylotic myelopathy, transverse myelitis, and spinal tuberculosis are the most common cause of non-traumatic myelopathy in the context of Bangladesh. [Journal of National Institute of Neurosciences Bangladesh, 2018;4(2):87-91] 87 damage or dysfunction of the spinal cord, meningeal or perimeningeal space with high morbidity and mortality 1 . The clinical presentations of nontraumatic myelopathies

Pattern recognition approach and clinico-radiological evaluation of compressive myelopathies at a tertiary care hospital

“…Similar results were found by the investigators of the study conducted in Bangladesh where investigators found among etiologies that cervical spondylotic myelopathy (31%) was most commonly diagnosed [25]. The cervical myelopathy syndrome was first described in 1952, in some cases performed by Brain and colleagues [26].…”

“…The present study included the majority of participants in between the age group of 51-60 years and showed a predominance of the male population. A study conducted in Bangladesh on patients with non-traumatic myelopathy also included the highest number of patients (26.0%) in the age group 51-60 years [14]. The age group of patients of a retrospective study conducted in Tikur Anbessa Hospital did not match with our participants as the majority were between the age group of 16-30 years of age but their data also showed male predominance [15].…”

“…The distribution was characteristic consisting of diffuse signal changes at the site of maximal compression and variable extension to the central cord as already enlightened by Mehali, TF. [25]. Results of the previous study revealed that the MRI of the cervical spine demonstrated spinal canal stenosis due to disc bulging and flavum hypertrophy at the C5/C6 and C6/C7 levels as well as hyperintense area over the C5-C7 levels on T2-weighted images [22].…”