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Four men,aged 24 to 60 years,presented with progressive weakness and hyperreflexia involving the lower extremities and distinct thoracic sensory levels ranging from T4 to T10.None of these patients had cervical pain,history of trauma,or upper extremity symptoms.Results of MRI scans of the thoracic spinal cord were unremarkable.Initially,one patient was suspected of having transverse myelitis and was treated with high dose steroids.All four patients were eventually found to have cervical spinal cord compression diagnosed by MRI.Three patients underwent surgery for decompression of the cervical lesion.While all 3 improved in lower extremity strength,2 had persistent discrete thoracic sensory levels postoperatively.Failure to diagnose cervical myelopathy because of the presence of a thoracic sensory level can delay appropriate treatment or lead to incorrect therapy.Persistence of a thoracic sensory level following surgery can occur. |
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cervical osteophyte
cervical spondylosis
herniated disc
herniated disc,cervical
MRI
MRI,abnormal
MRI,spinal cord
MRI,spine
myelopathy
sensory level
sensory level,false localizing
spinal cord,compression of
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