Radiation myelopathy

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By Edward J Dropcho MD

Radiation myelopathy is a relatively rare, but potentially devastating, complication of therapeutic irradiation. The growing use of stereotactic radiosurgery for spinal tumors may require a re-evaluation of the traditional dose-volume risk for radiation myelopathy as derived from standard fractionated radiation therapy. Dr. Edward Dropcho of Indiana University summarizes the clinical features, pathophysiology, and management issues for patients with radiation myelopathy.

Key points

  • Radiation myelopathy is a rare complication of modern therapeutic irradiation.
  • The generally accepted dose/fractionation parameters predicting the risk of radiation myelopathy may not necessarily apply to patients who receive a second course of radiation, concurrent radiation plus chemotherapy, or spinal stereotactic radiosurgery.
  • Most patients with radiation myelopathy are permanently neurologically disabled; there is no proven effective therapy.