Cervical myelopathy history and physical examination

Abstract

Cervical spondylotic myelopathy can be elusive in its diagnosis. Careful attention to detail in the history and physical examination of patients is required. The clinical presentation of a myelopathic patient involves gait changes, various combinations of upper and lower motor neuron signs and symptoms in the upper and lower extremities, bowel and bladder disturbances, classic abnormalities in hand function, hyperreflexia, and the presence of abnormal reflexes. Axial neck pain and radiculopathy may be superimposed. The differential diagnosis must consider pathological states that mimic cervical spondylotic myelopathy. A high degree of suspicion is often required for accurate diagnosis of this disorder.