Progressive Cervical Spondylotic Myelopathy: A Case Report Describing Evaluation and Management for a Patient in an Acute Care Inpatient Setting

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The patient was an 80 year old woman admitted to the hospital in an inpatient setting for pain control and further evaluation after a fall at home which resulted in severe low back pain and difficulty walking. Physical therapy was consulted to assess gait and transfer capabilities. At the time of initial physical therapy examination, the patient demonstrated poor bed mobility and transfer capabilities. She also demonstrated poor to fair upper or lower extremity strength with more pronounced weakness on the right. General hyperreflexia was noted (hyperactive bilateral deep tendon reflexes, positive bilateral Hoffman reflex, bilateral Babinski sign). A computed tomography scan of the head and magnetic resonance imaging of the cervical spine were ordered to assess for a cerebrovascular accident and cervical myelopathy, respectively. The cervical magnetic resonance imaging confirmed the diagnosis of cervical spondylotic myelopathy (Figure 1). The patient subsequently underwent successful surgical decompression laminoplasty from C3 to C6.