Cervical Spondylosis
A 58-year-old office worker presents with 8 months of neck pain radiating to both shoulders, progressive difficulty with buttons and writing, and unsteady gait. He reports dropping objects frequently and occasional electric shock sensations down his spine when flexing his neck. Examination reveals hyperreflexia in all limbs, bilateral positive Hoffman sign, inverted brachioradialis reflex, and wide-based ataxic gait. Grip strength is reduced bilaterally. MRI shows multilevel disc degeneration with osteophyte formation at C4-5, C5-6, and C6-7, with cord compression and intramedullary T2 signal change at C5-6. Regarding the pathophysiology and clinical features of cervical spondylotic myelopathy:
Mark each as TRUE or FALSE
CERVICAL SPONDYLOTIC MYELOPATHY (CSM) results from STATIC compression (disc/osteophyte complex, hype...
LHERMITTE SIGN (electric shock sensation down spine with neck flexion) indicates dorsal column invol...
Myelopathy causes LOWER motor neuron signs (hyporeflexia, flaccidity) in all extremities; Lhermitte ...
The NATURAL HISTORY of CSM is PROGRESSIVE in 75-80% of patients; deterioration may be STEPWISE (sudd...
The NURICK CLASSIFICATION grades functional disability: Grade 0 = root symptoms only, no cord involv...
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Click T (True) or F (False) for each option