The purpose of the study is to establish the role of magnetic resonance imaging (MRI) in the evaluation of various causes of compressive myelopathy, characterization of compressive lesions and to classify the lesions based on location into extradural / intradural compartments. Seventy patients who were clinically suspected to have compressive myelopathy were subjected for MRI. In this study, extradural compression due to degenerative changes (54.3%) was found to be the most common cause of compressive myelopathy, followed by infectious spondylitis (14.3%), post traumatic compressive myelopathy (12.8%), primary neoplasms & metastases (12.8%) and other causes (5.8%). There were 6 cases of intradural extramedullary pathology, remainder (64 cases) of the cases showed extradural location of pathology. MRI detected cord changes in 97% of cases with cord compression and also assessed the integrity of spinal cord, intervertebral discs and ligament after acute spinal trauma. MRI is very definitive, sensitive, accurate, though costly but very specific, noninvasive, radiation free modality for evaluation of compressive myelopathy
