Chronic Neck Pain with Progressive Upper Limb Weakness Due to Cervical Spinal Cord Compression

A woman in her 60s presented with chronic neck pain and progressive bilateral upper limb weakness, declining manual dexterity and intermittent electric shock sensations with neck flexion. Neurological examination demonstrated bilateral hyperreflexia, pathological reflexes, non-dermatomal weakness and impaired tandem gait, raising concern for cervical spinal cord involvement. Magnetic resonance imaging revealed severe central canal stenosis at C5–C6 with spinal cord compression and intramedullary T2 signal change, with additional degenerative changes at C6–C7. Conservative management was initiated while urgent neurosurgical referral was arranged. The patient subsequently underwent anterior cervical discectomy and fusion with postoperative neurological improvement. This case illustrates the importance of systematic neurological examination, early imaging and multidisciplinary management in degenerative cervical myelopathy.