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Updated: Jun 15, 2026
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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Compressive myelopathy mimicking transverse myelitis
Brendan J Kelley1, Bradley J Erickson, Brian G Weinshenker
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
The Neurologist
|March 12, 2010
Summary
Spinal stenosis can cause spinal cord compression, mimicking inflammatory conditions on MRI. Surgical decompression effectively treats compressive myelopathy, unlike corticosteroids.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Spinal cord compression on MRI can mimic inflammatory myelopathy, potentially delaying surgical intervention.
- Differentiating compressive myelopathy from inflammatory conditions like transverse myelitis is crucial for timely and effective treatment.
Observation:
- Five patients with suspected neuromyelitis optica were diagnosed with symptomatic cervical spinal stenosis.
- Patients presented with gradually progressive myelopathy over an average of 34.4 weeks.
- MRI revealed long T2 hyperintense lesions, with gadolinium enhancement localized to the compression site.
Findings:
- Compressive myelopathy symptoms showed poor response to corticosteroids.
- Surgical decompression led to significant improvement in symptoms of compressive myelopathy.
- Radiologic findings, including localized gadolinium enhancement, aided in distinguishing compression from myelitis.
Implications:
- Cervical spinal stenosis can present with intramedullary T2 hyperintensity mimicking inflammatory myelopathy.
- Accurate diagnosis relies on integrating clinical presentation with specific radiologic characteristics.
- Prompt surgical decompression is indicated for symptomatic cervical spinal stenosis causing myelopathy.
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