Case Report

Cervical Spondylotic Myelopathy, Be Vigilant of Miscellaneous Presentations: A Case Series


Background: Cervical spondylotic myelopathy (CSM) is the result of prolonged compression of the central spinal canal. Clinical and radiological manifestations of CSM could be misleading and physicians need to be vigilant while evaluating patients with neurologic complaints otherwise delay in diagnosis and management would happen that could finally lead to a poor outcome. The aim of this study was to report our series of patients with CSM to reiterate that CSM could have diverse manifestations, and it can be only identified if the physicians are aware and do a thorough investigation. The progressive nature of CSM makes its early diagnosis and subsequent appropriate management vital to avoid further complications.
Methods: A total of 10 patients who had diagnosed with CSM and undergone surgical treatment at our  institute evaluated according to the pre-operative and post-operative Nurrick classification and also pre-operative history and physical examination findings and elecrodiagnostic examination.
Conclusions: Because of progressive nature CSM and wide range of clinical manifestation, high index of suspicion, early diagnosis and early treatment prior to permanent spinal cord injury is recommended.

1. Rao RD, Gourab K, David KS. Operative treatment of cervical spondylotic myelopathy. J Bone Joint Surg Am.2006; 88(7): 1619-40.
2. Rao RD, Currier BL, Albert TJ, Bono CM, Marawar SV,Poelstra KA, et al. Degenerative cervical spondylosis:clinical syndromes, pathogenesis, and management. J Bone Joint Surg Am. 2007; 89(6): 1360-78.
3. Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. 2001; 9(6): 376-88.
4. Crandall PH, Batzdorf U. Cervical spondylotic myelopathy. J Neurosurg. 1966; 25(1): 57-66.
5. Clarke E, Robinson PK. Cervical myelopathy: a complication of cervical spondylosis. Brain. 1956; 79(3):483-510.
6. Lees F, Aldren Turner JW. Natural history and prognosisof cervical spondylosis. Br Med J. 1963; 2(5373): 1607-10.
7. Ferguson RJ, Caplan LR. Cervical spondylitic myelopathy. Neurol Clin. 1985; 3(2): 373-82.
8. Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain. 1972; 95(1):87-100.
9. Sadasivan K, Reddy R, Albright JA. The natural history of cervical spondylotic myelopathy. Yale J Biol Med.1993; 66(3): 235-42.
10. Albert TJ, Murrell SE. Surgical management of cervical radiculopathy. J Am Acad Orthop Surg. 1999; 7(6): 368-76.
11. Dvorak J, Janssen B, Grob D. The neurologic workup in patients with cervical spine disorders. Spine (Phila Pa 1976). 1990; 15(10): 1017-22.
12. Epstein NE, Epstein JA, Carras R. Coexisting cervical spondylotic myelopathy and bilateral carpal tunnel syndromes. J Spinal Disord. 1989; 2(1): 36-42.
13. Ratliff JK, Cooper PR. Cervical laminoplasty: a critical review. J Neurosurg. 2003; 98(3 Suppl): 230-8.
14. Rhee JM, Yoon T, Riew KD. Cervical radiculopathy. J Am Acad Orthop Surg. 2007; 15(8): 486-94.
15. Denno JJ, Meadows GR. Early diagnosis of cervical spondylotic myelopathy. A useful clinical sign. Spine (Phila Pa 1976). 1991; 16(12): 1353-5.
16. Lim MR, Huang RC, Wu A, Girardi FP, Cammisa FP.Evaluation of the elderly patient with an abnormal gait. J Am Acad Orthop Surg. 2007; 15(2): 107-17
IssueVol 2 No 3-4 (2015) QRcode
SectionCase Report(s)
Cervical spondylotic myelopathy Diagnostic errors Manifestations Misdiagnosis Mistreatment Surgical treatment

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How to Cite
Mirzashahi B, Mortazavi SMJ, Farzan M. Cervical Spondylotic Myelopathy, Be Vigilant of Miscellaneous Presentations: A Case Series. AJS. 2016;2(3-4):62-65.