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

Journal of International Medical Research, 2023 · DOI: 10.1177/03000605231178414 · Published: June 1, 2023

Spinal Cord Injury Neurology Orthopedics

Simple Explanation

Cervical spondylotic myelopathy (CSM) can sometimes present with atypical symptoms, such as lower limb sensory disturbances, which can lead to misdiagnosis. These atypical presentations are considered false localizing signs because the location of the symptoms doesn't match the expected location of the problem in the spine. This study presents three cases where patients with cervical spinal cord compression experienced lower limb sensory issues, highlighting the importance of considering cervical issues even when lower limb symptoms are present.

Study Duration

Not specified

Participants

Three Asian patients

Evidence Level

Level 4, Case Reports

Key Findings

1
Lower limb sensory disturbance can be a misleading symptom of cervical cord compression, potentially leading to misdiagnosis as a lumbar issue.
2
Anterior cervical discectomy and fusion (ACDF) surgery can effectively relieve both cervical cord compression and associated lower limb sensory disturbances.
3
A non-radicular pattern of lower limb sensory disturbance should prompt consideration of possible cervical cord compression.

Research Summary

This paper presents three case reports of Asian patients who experienced lower limb sensory disturbance due to cervical cord compression, which was initially misdiagnosed as lumbar spondylosis. The patients underwent anterior cervical discectomy and fusion, which relieved the spinal cord compression and resolved the lower limb sensory disturbances. The authors emphasize the importance of considering cervical cord compression in patients presenting with lower limb sensory disturbance, especially when symptoms don't follow a typical radicular pattern.

Practical Implications

Diagnostic Awareness

Clinicians should be aware that lower limb sensory disturbances can be a sign of cervical cord compression, even in the absence of classic cervical symptoms.

Comprehensive Examination

A thorough physical examination, including assessment of cervical spine and neurological function, is crucial for patients presenting with atypical lower limb symptoms.

Surgical Intervention

Anterior cervical discectomy and fusion can be an effective treatment option for patients with cervical cord compression and associated lower limb sensory disturbances.

Study Limitations

1
Small sample size of only three case reports.
2
Lack of detailed mechanism explaining the relationship between cervical cord compression and lower limb sensory disturbance.
3
Limited follow-up period of only 3 months.

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