Cervical myelopathy

Case contributed by Dr Derek Smith

Presentation

Tingling and numbness in both hands and right leg. Lhermitte's phenomenon with neck extension. 4/5 weakness in finger abduction and reduced pinprick sensation in medial forearm (R>L). Upgoing right plantar response.

Patient Data

Age: 45
Gender: Male
Modality: MRI

Severe spinal canal stenosis noted from C4 to C7 particularly at C5/6 and C6/7 due to degenerative disc bulges and congenitally narrow spinal canal which resulting in complete effacement of the CSF and spinal cord compression at these levels. There is high T2 signal noted within the cord due to either oedema or myelomalacia. Disc bulge also noted at C4/5 without any myelopathic signal change. Marked bilateral C6/7 foraminal narrowing, worst on the left. Mild foraminal narrowing through remainder of cervical spine.

Summary

  • C5/6, C6/7 compressive cervical myelopathy
  • Moderate C6/7 foraminal stenosis

Case Discussion

This patient had predominantly sensory symptoms with mild motor deficits and was referred to neurosurgical services for their opinion on decompression.

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Case Information

rID: 35223
Case created: 27th Mar 2015
Last edited: 6th Feb 2016
Inclusion in quiz mode: Included

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