Abstract
We present a case describing the management of a woman with severe, functionally limiting cervical myeloradiculopathy in the setting of congenital cervical canal stenosis and Arnold-Chiari I malformation. The subject is a 57-year-old woman with prior anterior cervical discectomy and fusion who presented with left-sided neck pain associated with radiculopathy, migraine, gait incoordination, and cervical dystonia. Cervical stenosis and Chiari malformation were confirmed using MRI. Conservative management with botulinum toxin, oral muscle relaxants, and cervical brace led to gradual exacerbation of symptoms. Due to failure of conservative management, surgical decompression with C3-C6 posterior laminoplasty was performed, resulting in complete resolution of all symptoms and markedly improved quality of life. This case reports a severe and nonspecific presentation of cervical myeloradiculopathy. Surgery for cervical myeloradiculopathy is controversial, and conservative therapy is initially preferred. However, in this case, conservative treatments likely led to paraspinal weakness, cervical hypermobility, and biomechanical instability, resulting in exacerbation of symptoms. Stretch/shear forces have been postulated to accelerate cerv...Continue Reading
References
Dec 16, 2003·Spine·Tateru ShiraishiTakeshi Ikegami
Apr 15, 2004·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Dan S HeffezCharity G Moore
Jan 6, 2007·Neurosurgery·James S HarropAshwini Sharan
Jan 6, 2007·Neurosurgery·Eli M Baron, William F Young
Apr 25, 2007·British Journal of Neurosurgery·Marc BullockGerry Towns
Sep 23, 2008·Journal of Manipulative and Physiological Therapeutics·Donald R Murphy, Jacqueline L Beres
Jan 20, 2010·Journal of Spinal Disorders & Techniques·Alagappan SivaramanRobert J Crawford
Aug 22, 2013·Spine·Spyridon K KaradimasMichael G Fehlings
Oct 19, 2013·Experimental and Therapeutic Medicine·Ling-DE KongZi-Kun Shang
Aug 1, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Amy KilleenSteven Hwang
Feb 11, 2015·Mayo Clinic Proceedings·Steven P Cohen
Feb 13, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jörg Klekamp
Mar 16, 2017·Archives of Orthopaedic and Trauma Surgery·Han ChangByung-Wan Choi