CERVICAL MYELOPATHY DUE TO CERVICAL DISC HERNIATION A CASE REPORT

Tatjana Deleva Stoshevska; Bojan Stoshevski; Sofija Nikoloska; Marko Nikoloski; Dimitar Veljanovski; Andrea Nancheva Bogoevska

Tatjana Deleva Stoshevska City General Hospital 8th September, Skopje, North Macedonia
Bojan Stoshevski University Clinic of pulmonology and allergology, Skopje, North Macedonia
Sofija Nikoloska University Ear, Nose and Throat Clinic, Skopje, North Macedonia
Marko Nikoloski University Clinic of Surgical Diseases St. Naum Ohridski, Skopje, North Macedonia
Dimitar Veljanovski City General Hospital 8th September, Skopje, North Macedonia
Andrea Nancheva Bogoevska City General Hospital 8th September, Skopje, North Macedonia

Abstract

Cervical myelopathy is a progressive degenerative disorder resulting from spinal cord compression, most commonly due to spondylotic changes and intervertebral disc herniation. It presents with a wide spectrum of neurological deficits, including walking disturbance, limb weakness, sensory impairment, and upper motor neuron signs. Early recognition is essential, as advanced disease may lead to irreversible neurological damage. We present the case of a 63-year-old woman with progressive quadriparesis, walking impairment, and sensory disturbances following minor trauma. Neurological examination revealed upper motor neuron signs and intrinsic hand muscle atrophy. Magnetic resonance imaging of the cervical spine demonstrated multilevel degenerative disc disease with severe spinal canal stenosis and spinal cord compression, accompanied by intramedullary signal changes consistent with compressive myelopathy. Despite neurosurgical indication for operative treatment, the patient declined surgery and was managed conservatively with physical therapy, resulting in partial clinical improvement. This case highlights the importance of thorough clinical evaluation and neuroimaging in the diagnosis of cervical myelopathy and underscores the need for timely recognition and appropriate management to prevent long-term disability.

Keywords: cervical myelopathy, cervical spondylosis, spinal canal stenosis, spinal cord compression, magnetic resonance imaging.

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