MRI of radiation myelitis: a report of a case treated with hyperbaric oxygen

Radiation therapy is commonly applied as a primary or adjuvant therapy for malignancies. One of the major complications following radiation therapy is the necrosis of the otherwise normal surrounding soft tissues and/or bone. Post-radiation myelopathy rarely occurs when the spinal cord is included within the radiation field, in cases of high total radiation doses or for high radiation doses per fractionation. Up until the present, no tolerance dose for the spinal cord has accurately been defined and no treatment has proved satisfactory. Hyperbaric oxygen therapy is already currently used as adjuvant treatment for osteoradionecrosis and for radionecrosis of soft tissues with satisfactory results, whereas results for the treatment of post-attinic myelitis were contradictory. The aim of our report is to describe a case of radiation myelitis with a progressive improvement in the clinicoradiologic picture following hyperbaric oxygen treatment.