Turkish Journal of Geriatrics 2015 , Vol 18, Issue 2
A LATE DIAGNOSED CERVICAL MYELOPATHY CASE
Feyza Ünlü ÖZKAN1, Tuba NAZLIGÜL1, Fatma Nur SOYLU BOY2, İlknur AKTAŞ1
1Fatih Sultan Mehmet Training and Research Hospital Physical Medicine and Rehabilitation Clinic, Ä°STANBUL
2Fatih Sultan Mehmet Training and Research Hospital Radiology Clinic, Ä°STANBUL
Cervical spondylotic myelopathy is the most important cause of myelopathy in the elderly. It is defined as spinal cord dysfunction secondary to the compression of the cord caused by degenerative disease of the cervical spine. Cervical spondylotic myelopathy is a slowly progressing disease and disability caused by cervical spondylotic myelopathy can be life threatening. Despite its severity, it may remain undiagnosed for a long time. We report the case of an 80-year-old female with cervical spondylotic myelopathy leading to paraparesis. She progressively had difficulty in walking, which worsened in the last year. She had knee pain for several years, with a known diagnosis of bilateral gonarthrosis. She had been walking with the aid of a cane when her symptoms worsened and became unable to walk independently in the past months. Her walking disability was attributed to advanced bilateral gonarthrosis. Upon physical examination, she had bilateral knee contractures, extensor plantar responses, and tonus was slightly increased in the legs. Muscle strength was also decreased in the right upper and bilateral lower extremities. Magnetic resonance imaging of the cervical spine revealed spondylotic myelopathy from C3 to C6. Cervical decompression and a stabilization operation were performed. She responded well to the rehabilitation programme. Cervical spondylotic myelopathy should always be considered for elderly patients with walking disabilities, and physicians should be aware that this disease develops insidiously and coexisting diseases leading to disability may mask the symptoms and delay the diagnosis. Keywords : Cervical Vertebrae/physiopathology; Spinal Cord Diseases; Spondylosis/therapy