Anterior Sensory Myelopathy: A Retrospective Observational Case Series of an Overlooked Neurological Disorder

Jeffrey W Cozzens* and Alex P Michael

Department of Surgery, Southern Illinois University School of Medicine, USA

^*Correspondance to: Jeffrey W Cozzens 

 PDF  Full Text DOI: 10.25107/2474-1647.2699

Abstract

Background: Individuals with cervical myelopathy can sometimes present with more subtle signs and symptoms of loss of pain and temperature sensation from compression of the anterolateral spinothalamic tract without involvement of other spinal cord tracts. It is necessary to recognize early and subtle forms of myelopathy. Objective: The purpose of this report is to describe a series of patients who present with a mostly sensory cervical myelopathy from a radiographically documented spinal cord compression of the anterolateral spinothalamic tract. Methods: This study is a retrospective case series. Individuals were selected who presented with radiographic documentation of cervical spinal cord compression and loss of pain and/or temperature sensation below the level of the compression. Individuals who exhibited signs of corticospinal tract dysfunction (weakness, hyperreflexia, ataxia and/or pathological spinal reflexes) were excluded. Results: Seven individuals (age range 36 to 52, mean 42.4) were identified as having loss of sensation to pain and/or temperature below and contralateral to the level of anterior spinal cord compression. In all cases, the compression was due to a cervical herniated intervertebral disc. No patient had lower extremity weakness, hyperreflexia, or spasticity. No patient had spinal sensory evoked potential abnormality. Conclusion: Cervical disc compression of the anterior spinal cord can lead to dysfunction of pain and temperature sensation without causing typical signs of myelopathy. Most patients who present with this myelopathy syndrome also present with pain and are likely treated with conservative medical therapy. This series highlights a very subtle form of myelopathy that is not widely recognized.

Keywords

Spinothalamic tract; Myelopathy; Cervical spine; Neuroanatomy; Neurophysiology

Cite the article

Cozzens JW, Michael AP. Anterior Sensory Myelopathy: A Retrospective Observational Case Series of an Overlooked Neurological Disorder. Clin Surg. 2020; 5: 2699..