Cervical myelopathy after neglected, minor cervical spine injury: the importance of early and continuous rehabilitation - case report

Degenerative cervical myelopathy (DCM) is adults' most common form of spinal cord injury Its clinical symptoms result from spinal cord compression due to acute and chronic spinal column processes. However, DCM's exact pathophysiology is uncertain. Due to difficulty in diagnosis, many patients suffering from DCM remains undiagnosed until the symptoms become debilitating. The subject of this study is a 42-year-old male with no previous medical history. Neurological symptoms suddenly appeared three months prior to the hospital admission. An MRI revealed hernias of intervertebral discs between C4-C5, C5-C6, and C6-C7 and myelopathy in the most compressed parts of the spinal cord (C4-C5-C6 level). Cervical spondylodesis from anterior access, C3-C6 laminectomy, and spinal decompression were performed. The patient's postoperative symptoms worsened suddenly with the presence of tetraparesis. After prolonged rehabilitation, satisfactory motor function was regained. No possible cause for the development of myelopathy was apparent, although the patient recalled experiencing an injury 20 years earlier. Despite cervical injuries being challenging to diagnose and presenting no clinical symptoms at first, an almost complete recovery after the late onset of symptoms is possible with proper surgical treatment and rehabilitation.