An appraisal of timely magnetic resonance imaging in diagnosing spinal cord compression

Abstract

Introduction: Spinal cord compression is a very debilitating condition and could be secondary to many causes. Urgent magnetic resonance (MR) imaging of the spine is crucial in making the diagnosis and guiding further management. Our objectives were to assess the nature of MR imaging requests, the diagnostic yield, and the subsequent management according to relevant MR imaging findings. Methods : We focused on all the urgent MR imagings of the spine conducted from July 1, 2007 to December 31, 2007. Clinical data, including the demographical information, presenting symptoms, radiological diagnosis, waiting time for MR imaging and treatment, was reviewed. Results : A total of 33 cases of urgent MR imaging of the spine were performed. Patients were aged 29-85 years, with 18 males and 15 females. Most of them (84.8 percent) presented with neurological symptoms. 84 percent of the MR imaging was performed within 24 hours. 76 percent of the examinations yielded significant cord compression, of which 56 percent were due to vertebral metastasis, while others were due to epidural haematoma (12 percent), infective spondylodiscitis (8 percent), vertebral fracture (8 percent) and disc herniation (16 percent). Of the vertebral metastasis patients, 43 percent had one region imaged. 64 percent of the cord compression patients received surgical treatment or radiotherapy, with a mean waiting time of 1.7 days. Conclusion: The urgent MR imaging spine service was able to react promptly with a high diagnostic yield. One-third of the patients with vertebral metastasis had multiple levels involved, and imaging of the whole spine would be useful.