Cervical Spondylotic Myelopathy

Unbalanced

Step 1: View clinicals

A 54 year old man presents with weakness and numbness of his left arm for 8 months. He also experienced some difficulty in walking, as he felt unbalanced and undexterous. His medical and family histories are unremarkable. He is not on any medications.


Step 2: Order all relevant investigations

X-ray Cervical Spine

The X-ray shows decreased disc heights in the vertebrae C3 to C7, along with bony proliferation of the anterior bodies and articular processes, and varying degrees of foramen compromise.

MRI Cervical Spine

There is cervical spinal stenosis affecting the vertebrae C3 to C7, with compression of the spinal cord

Duplex L/s Subclavian Artery

The color flow duplex scan of the left subclavian artery is completely normal.

Nerve Conduction Studies

Nerve conduction studies of the L/s ulnar and radial nerves are completely normal.


Step 3: Select appropriate management

Cervical Laminoplasty
Cervical Immobilization
NSAIDs
Bisphosphonates


Score: ★★☆