This is a 32 y/o man who two weeks prior experienced the painless onset of tingling of both feet extending up to his calves. He had no weakness. One week later, he noticed that each time he hyperextended his neck there was a tingling pain that would shoot around from his back to his nipples and this would go away if he returned his neck to a normal position. Four days later, he began having difficulty initiating a stream of urine and by this time his balance had deteriorated to the point that he was forced to clutch onto furniture just to walk in his condo. On examination, he had weakness for hand grip of the right hand, inability to feel a vibrating tuning fork on the toes, loss of pin sensation all the way up to a point just between his shoulder blades (in the center of his back) and a wide base to his stance as he was very unsteady.
The MRI of the cervical spine demonstrates congenital narrowing of the spinal canal. In addition, there are relatively small disc bulges and protrusions at several levels which in combination with the congenital spinal stenosis results in injury of the cervical spinal cord.
DIAGNOSIS: Acute Cervical Cord Compression from Cervical Spondylosis
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