Degenerative Cervical Myelopathy: A Case Report of Delayed Diagnosis in a Younger Man

Abstract

BACKGROUND: Degenerative cervical myelopathy is most caused by degenerative cervical stenosis in an over 55-year age group. However, it may occur in younger ages, most commonly due to large cervical disc protrusions.

CASE PRESENTATION: The case report describes a 42-year-old male, who presented with progressive ataxia and upper limb discoordination over a 4-year period. He was initially diagnosed and treated for bilateral carpal tunnel releases. Following his persistent symptoms, cervical magnetic resonance imaging was performed, which confirmed a large cervical C4/5 disc protrusion.

OUTCOME AND FOLLOW-UP: Although initially managed with observation, his continuing decline resulted in emergency cervical decompression. Surgery for myelopathy aims to prevent further deterioration, and timely treatment is therefore critical to restoring function.

DISCUSSION: This case highlights the difficulties faced by people with degenerative cervical myelopathy to obtain a diagnosis and treatment, and the consequences. Myelopathy is an important differential diagnosis to consider irrespective of age. Where suspected, a cervical spine MRI should be requested. JOSPT Cases 2022;2(4):220–225. Epub: 12 October 2022. doi:10.2519/josptcases.2022.11088