"Numb, clumsy hands" and high cervical spondylosis

Area of Science:

• Neurology
• Neurosurgery
• Orthopedics

Background:

• Cervical spondylosis can lead to cervical myelopathy, compressing the spinal cord.
• High cervical myelopathy (C3-C5) may present with unusual neurological deficits.

Purpose of the Study:

• To describe a distinctive clinical syndrome associated with high cervical myelopathy and cervical spondylosis.
• To highlight diagnostic challenges and the importance of early recognition.

Main Methods:

• Retrospective analysis of 13 patients with cervical spondylosis and C3-C5 myelopathy.
• Clinical assessment, cervical myelography, and surgical/autopsy confirmation of pathology.

Main Results:

• Patients presented with "numb, clumsy hands" and hand stereoanesthesia.
• Sensory loss (position, vibration) was more severe in hands than legs.
• Primary sensory modalities, motor, and bladder functions were relatively spared.
• Cervical myelography was critical for diagnosis, often after initial misdiagnosis.

Conclusions:

• A distinct syndrome of hand sensory disturbances occurs in high cervical myelopathy due to cervical spondylosis.
• Early diagnosis and intervention are essential to mitigate neurological disability.
• This presentation is an unusual but significant manifestation of cervical myelopathy.