Differential Diagnosis and Treatment of Cervical Spondylotic Myelopathy Mimicking Myelitis in an Adolescent Patient - A Case Report - (청소년기에 발생한 척수염으로 오인되었던 경추 척수증의 감별진단 및 치료 - 증례보고 -)

Il-Yeong Hwang (황일영); Jae-Ryong Cha (차재룡); 김용찬; Sun-Jae Park (박선재); 정승현

Differential Diagnosis and Treatment of Cervical Spondylotic Myelopathy Mimicking Myelitis in an Adolescent Patient - A Case Report -

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2017, 24(3), pp.198~202
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

Il-Yeong Hwang ¹, Jae-Ryong Cha ¹, 김용찬 ², Sun-Jae Park ³, 정승현 ³

¹울산대학교
²경희대학교
³울산대학교 의과대학 울산대학교병원 정형외과학교실

Accredited

ABSTRACT

Study Design: Case report Objectives: This study introduces an interesting case of adolescent cervical myelopathy with atypical cervical magnetic resonance imaging (MRI) findings. A differential diagnosis was made, followed by successful surgical treatment. Summary of Literature Review: A careful differential diagnosis of high signal intensity on T2-weighted cervical MRI is necessary if there is no evidence of cervical stenosis. Recent reports have suggested that the differential diagnosis should be based on a comprehensive analysis of data, including brain MRI, a cerebrospinal fluid examination, and empirical steroid treatment. Materials and Methods: A 17-year-old male patient complained of upper extremity weakness, gait disturbance, and decreased sensation in the upper extremity. Cervical spine MRI findings suggested C3/4 disc herniation, moderate cervical stenosis, and high signal intensity in the spinal cord. A differential diagnosis was made between cervical myelopathy and myelitis. Results: Decompression and posterolateral fusion of C3/4 were performed in a 17-year-old patient with cervical myelopathy without significant cervical stenosis. Postoperatively, upper extremity sensation and weakness and gait disturbance showed improvement, and the Japanese Orthopedic Association score improved to 17 points at 6 months after surgery. Conclusions: In patients with cervical myelopathy showing high signal intensity on T2-weighted imaging without evident spinal stenosis, a differential diagnosis should be made between cervical myelopathy and myelitis; surgical decompression can be an effective treatment choice upon the diagnosis of cervical myelopathy.

KEYWORDS

Cervical, Myelopathy, Magnetic resonance imaging, Differential diagnosis, Decompression

Citation status

* References for papers published after 2023 are currently being built.

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Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03