Degenerative Spine
A 62-year-old woman presents with 6 months of progressive hand clumsiness, gait imbalance, and bilateral leg stiffness. Examination reveals hyperreflexia in all four limbs, positive Hoffman sign bilaterally, and an ataxic gait. She can walk unaided but has difficulty with fine motor tasks. MRI shows multilevel degenerative stenosis from C3-C7 with cord compression and T2 hyperintensity within the cord at C5-6. The surgeon discusses the natural history, prognosis, and surgical options including anterior versus posterior approaches. Regarding cervical myelopathy assessment and management:
Mark each as TRUE or FALSE
Cervical myelopathy is a CORD COMPRESSION syndrome characterized by UPPER MOTOR NEURON signs includi...
NURICK CLASSIFICATION grades functional impairment: Grade 0 = root signs only; Grade 1 = cord signs,...
Myelopathy produces LOWER motor neuron signs (hyporeflexia, flaccidity); the natural history is beni...
The natural history is PROGRESSIVE in 80% of patients (20% stepwise deterioration, 60% gradual decli...
Surgical approach selection: ANTERIOR (ACDF/corpectomy) for 1-2 level anterior compression (disc, os...
Answer the questions to see explanations
Click T (True) or F (False) for each option