Cervical spondylotic myelopathy with vitamin B₁₂ deficiency: Two case reports

Although it has been observed that a vitamin B₁₂ (VB₁₂) deficiency may lead to defects in the nervous system, there is a lack of studies elucidating whether VB₁₂ has a role in the pathogenesis of cervical spondylotic myelopathy (CSM). The present study describes two cases of CSM observed in the clinic, where the patients presented with common characteristics of the typical clinical symptoms; however, T2-weighted magnetic resonance imaging examinations revealed that although the degree of spinal cord compression was not serious, the spinal cord exhibited significant high signal changes. At the same time, the serum VB₁₂ levels of the two patients were lower compared with those of normal controls. The symptoms of the patients improved following anterior cervical decompression surgery and VB₁₂ replacement therapy. The incidence of CSM in the two patients may have been correlated with a lack of VB₁₂. Therefore, it is recommended that the serum VB₁₂ levels are checked in cases of CSM where the standard imaging and clinical manifestations do not fully match.