Role of MRI in Functional Prognosis of Metastatic Cord Compromise

Abstract

Objective: Primary objective of our study was to establish the strength of association of MRI
findings at presentation with clinical outcome of patient i.e Motor deficit and Sphincter control.
Secondary objectives included Incidence of tumors affecting spinal cord and Correlation of motor
weakness and sphincter control with patient presentation.
Methods: This retrospective study was conducted in Department of Radiology,Shaukat
Khanum Memorial Cancer Hospital and Research Center, Lahore, between Jan 2013 and June
2013. The study included series of 64 patients, including 38 men and 26 women, ranging between
35 and 70 years (mean, 48.5±13 years), presenting with symptoms and signals of spinal stenosis.
Results: Results for tumors involving less than 25%, N: 24 (37%) were included in this group. All
showed stable appearance or improvement on follow up. Data was not significant (when
expecting stability/improvement in 75-100% of patients).When further divided into 2 groups.
Improvement was seen in (6) p> 0 and stability in (18) p< 0.05 significant. Results for tumors
involving less than 25-50%,N: 26 (40.6%). 45% showed improvement, when expecting stability/
improvement in 50-75% of patients. Data was statistically insignificant data with p >
0.05.Moreover, the results for tumors involving less than 50-75%, N: 4 (6.2%). 50% showed
improvement/stability post treatment. 50% showed progression. In patients tumors involving less
than 75-100%, N: 10 (15%). 20% showed improvement. Statistically significant data with p<
0.05.Cord signal was compromised in 28 (34.3%). 22 had muscular weakness. Improvement was
seen in 45%. 12 had sphincter dysfunction. 50% showed improvement in clinical symptoms.
Conclusion: MRI has a potential to predict the functional outcome in patients with metastatic
cord compromise.