Infrequently diagnosed common gait disorder in outpatients with cervical spinal stenosis: A retrospective cohort study

Abstract

Background. Degenerative cervical myelopathy (DCM) is poorly recognized and infrequently diagnosed. Objectives. To identify symptoms or signs in the lower extremities physically and radiologically in outpatients with DCM. Methods. In 2023, a retrospective cohort study was performed to review the medical records from 2016 to 2020. A total of 28 (24 women) patients were included. All patients were physically examined. Sagittal magnetic resonance imaging (MRI) of the cervical spinal canal was performed and its anteroposterior diameter was calculated in patients with hyperreflexia and/or gait disorder. Results. Sixteen (13 women) patients presented with symptoms or signs in the lower extremities only (group A) and 12 patients (11 women) presented with those in the upper and lower extremities (group B). The mean [SD] ages were 70.06 [17.49] and 58.67 [11.80] years, respectively. Pseudo-polyneuropathic patterns of sensory dysfunction in the lower extremities were identified in 14 patients (88%) of group A and 11 patients (92%) of group B. Also, 16 patients (100%) of group A and 11 patients (92%) of group B presented with hyperreflexia of the triceps and/or patellar tendons. Sagittal MRI showed a minimum value of stenosis at the C5-6 level in 9 patients (56%) of group A and 7 patients (58%) of group B. The mean [SD] anteroposterior diameters at the most stenotic level in patients of groups A and B were 9.63 [2.02] and 10.17 [1.23] mm, respectively. Conclusion. Hyperreflexia of the triceps and/or patellar tendons is one of the most important neurological findings to suspect DCM.