spinal stimulator dorsal column myelopathy causing

At 26, she frequently stumbled and needed to rely on the railing to walk down the stairs and was unable to close a button or use chopsticks. By the age of 20, she frequently incurred burn injuries on her right hand due to impaired temperature sense.

At the age of 12, the patient was aware of muscle weakness of her right hand and experienced difficulty throwing and using a tennis racket. The subject was a 30-year-old female with no developmental problems in early childhood. Long-term follow-up is recommended for these cases because they may require early surgical treatment.

However, some cases can develop advanced myelopathy with long tract signs. Most cases of cervical flexion myelopathy as represented by Hirayama disease have a self-limiting benign prognosis. However, her spastic gait and muscle atrophy remained. After surgery, she gained mild improvement in both muscle strength and her hand’s movement. Posterior fusion surgery was performed to prevent progression of the myelopathy. During flexion the spinal cord was stretched, resulting in contact with the posterior wall of the vertebrae. She had local kyphosis with a large (61°) flexion range of motion. Although the space available for the spinal cord was large, the spinal cord was highly atrophic. Her hands were frozen into a ‘claw-like’ gesture and her intrinsic muscles were highly atrophic. Despite conservative treatment using a cervical collar, she developed prolonged bilateral muscle atrophy, sensory disturbance and spastic gait, along with bladder and rectal disturbances. We report on a 30-year-old female whose onset presented as unilateral muscle atrophy of the right hand in her teens. However, in rare cases the damage can spread to the white matter and present as long tract signs. Generally, the pathology is limited to the gray matter of the anterior horns in the lower cervical spinal cord. Hirayama disease, a type of cervical flexion myelopathy, is a rare neurological disease characterized by muscular atrophy of the forearms and hands.

Spinal stimulator dorsal column myelopathy causing