Radiation myelopathy

Radiation myelitis has long been recognised as a sinister consequence of sp inal irradiation and has limited the acceptable dose of therapeutic radiati on to the cord. Over the past 10 years, the pathogenesis has been increasin gly understood through the use of animal models. The importance of 'dose pe r fraction' and 'inter-fraction interval' have been incorporated into new m athematical models which suggest that, for small fractions, the cord may to lerate higher doses of radiation than was previously thought. Clinical reco gnition of the condition has improved through the description of characteri stic magnetic resonance imaging changes. However little advance has been ma de in its treatment, Curr Opin Neurol 11:627-632. (C) 1998 Lippincott Willi ams & Wilkins.