An exploration on the radiological features associated with motor deficits in patients with metastatic epidural spinal cord compression

Y.-S. Liu, S.-B. Liu, D.-F. Li, H.-T. Fan, J.-Y. Huai, J. Guo

Department of Orthopaedics, the No. 307 Hospital of People’s Liberation Army, Beijing, China. sbliu_med@163.com

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• Orthopedics

OBJECTIVE: This study was designed to explore the radiological features associated with the motor deficits in patients with metastatic epidural spinal cord compression (MESCC).

PATIENTS AND METHODS: The patients with MESCC admitted in our department from July 2006 to December 2008 were included in this analysis. The data on the radiological features of affected vertebrae showed by computed tomography or magnetic resonance imaging scan and the motor deficits level assessed as paralysis or non-paralysis according to Frankel Classification Grading System were collected. A multiple regression model was established to indentify the radiological features associated with the paralysis status of MESCC patients.

RESULTS: A total of 56 patients with MESCC were included in this study. All patients had invasion of vertebral body, main affected vertebrae was consecutive in 75% (8/12) of patients with lesions of upper thoracic spine and/or cervicothoracic junction and 18.18% (8/44) of patients with lesions of cervical spine, middle thoracic spine, lower thoracic spine, and lumbar spine. The paralysis status was consisted with the finding of epidural space involvement. A linear relationship between paralysis status and the radiological features including lamina involvement, retropulsion of posterior wall, and location in upper thoracic spine and/or cervicothoracic junction was detected by the “optimal” regression equation, of them lamina involvement has the greatest impact on paralysis status.

CONCLUSIONS: The radiological features including lamina involvement, retropulsion of posterior wall, and location in upper thoracic spine and/or cervicothoracic junction were significantly associated with the motor deficits of patients with MESCC, which might be helpful to identify these patients who were susceptible to motor deficit, especially lamina involvement.

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