Cervical cord compression with lower limb sensory disturbance: three case reports and a literature review

J Int Med Res. 2023 Jun;51(6):3000605231178414. doi: 10.1177/03000605231178414.

Abstract

Lower limb sensory disturbance can be a false localizing sign of cervical spondylotic myelopathy. It may lead to delayed or missed diagnosis, resulting in an inappropriate management plan, especially in the presence of concurrent lumbar lesions. Three Asian patients with lower limb sensory disturbance were ineffectively treated in the lumbar region. Magnetic resonance imaging showed cervical disc herniation and cervical spinal cord compression. The patients underwent anterior cervical discectomy and interbody fusion using a stand-alone cervical interbody fusion cage. Postoperative imaging showed that the spinal cord compression was relieved. On the first postoperative day, the lower limb sensory disturbance was also relieved. The patients showed good recovery at the 3-month postoperative follow-up. These three cases of cervical cord compression with lower limb sensory disturbance were easily misdiagnosed as lumbar spondylosis. Anterior cervical discectomy and fusion had a good therapeutic effect. Therefore, the presence of lower limb sensory disturbance in a non-radicular classic pattern should always raise suspicion of a possible cord compression at a higher level.

Keywords: Cervical spine; cervical spondylotic myelopathy; false localizing; lower limb sensory disturbance; magnetic resonance imaging; tract pain.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Cervical Cord*
  • Humans
  • Magnetic Resonance Imaging
  • Spinal Cord Compression* / diagnosis
  • Spinal Cord Compression* / diagnostic imaging
  • Spinal Cord Diseases* / surgery
  • Spondylosis* / complications
  • Spondylosis* / diagnostic imaging
  • Spondylosis* / surgery