Cervical Spine Disorders
A 62-year-old man presents with 18 months of progressive difficulty with hand coordination, trouble with buttons, and unsteady gait. He reports numbness in both hands and occasional urinary hesitancy. Examination reveals hyperreflexia in all four limbs, Hoffman's sign positive bilaterally, a positive Lhermitte's sign, and gait ataxia. Grip strength is reduced, and there is myelopathic hand (finger escape sign positive). MRI shows multilevel (C3-C7) cervical stenosis with cord compression and T2 signal change within the cord. Regarding cervical spondylotic myelopathy:
Mark each as TRUE or FALSE
Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in adults ...
Clinical features include upper motor neuron signs (hyperreflexia, Hoffman's sign, Babinski sign, cl...
CSM is rare in adults; it presents with lower motor neuron signs; hyporeflexia is typical; Hoffman's...
Surgical options include anterior approaches (ACDF for 1-2 levels, corpectomy for 3+ levels, anterio...
MRI findings include T2 hyperintensity in the cord (indicates edema or myelomalacia, poor prognosis ...
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Click T (True) or F (False) for each option