Degenerative cervical myelopathy

Question 1

Risk factors for degenerative cervical myelopathy

Answer 1

• smoking (affects intervertebral discs)
• genetics
• occupation (high axial loading)

Question 2

Clinical features

Answer 2

• Pain (neck, upper or lower limbs)
• Loss of fine motor function (can’t button shirt)
• Arm or leg weakness/stiffness
  numbness
• Bladder/bowel dysfunction

Question 3

How do we perform Hoffman’s sign to assess for cervical myelopathy?

Answer 3

• flicking one finger on a patient’s hand
• positive test results in reflex twitching of the other fingers on the same hand

Question 4

Gold standard diagnostic investigation

Answer 4

MRI cervical spine

• disc degeneration
• ligament hypertrophy
• cord signal change.

Question 5

Definitive management of degenerative cervical myelopathy

Answer 5

• decompressive surgery