Cervical myelopathy

Signs & symptoms

• Clumsiness in hands or feet.
• Gait disturbance.
• Loss of bladder/ bowel/ sexual function.
• Upper motor signs (positive babinski/ brisk reflexes/clonus)
• Lhermitte’s sign.
• Finger escape sign.

Risk factors

• Age- more common in elderly.
• Congenitally narrow canal.
• Current or smoking history.

Rapidly deteriorating – discuss with on call/refer to ED.

Significant disability – urgent referral to Orthopaedics.

Stable/mild-moderate disability – routine Orthopaedic referral with safety netting for progression.