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Spine
intermediate
X-Type

Cervical Myelopathy Diagnosis Treatment

Degenerative Spine

A 62-year-old man presents with progressive difficulty with fine motor tasks (buttoning shirts, writing), unsteady gait, and numbness in both hands over 12 months. Examination reveals hyperreflexia in upper and lower extremities, positive Hoffmann sign bilaterally, broad-based spastic gait, and decreased proprioception in the feet. MRI shows multilevel cervical spondylosis with cord compression at C4-5, C5-6, and C6-7, with T2 hyperintensity in the cord at C5-6. Regarding degenerative cervical myelopathy:

Mark each as TRUE or FALSE

A

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults...

B

Physical examination findings include upper motor neuron signs (hyperreflexia, Hoffmann sign, Babins...

C

DCM presents with lower motor neuron signs; hyporeflexia is the hallmark finding; Hoffmann sign indi...

D

MRI findings include disc/osteophyte cord compression, T2 hyperintensity in the cord (poor prognosti...

E

Surgical approach selection: anterior (ACDF, corpectomy) for 1-2 level ventral compression with pres...

Answer the questions to see explanations

Click T (True) or F (False) for each option