In a patient with suspected cervical myelopathy, what gait abnormality is commonly observed?

• A. Spastic gait
• B. Hemiparetic gait
• C. Ataxic gait
• D. Waddling gait

Answer: (B)

In cervical myelopathy, the spinal cord is compressed in the neck, so the downward effects are UMN signs affecting both legs. This usually shows up as a spastic gait: the legs feel stiff and move with a hesitant, stiff pattern, often with increased tone, brisk reflexes, and sometimes a scissoring of the legs due to adductor spasticity. It reflects bilateral corticospinal tract involvement below the level of compression, not a one-sided weakness. A hemiparetic gait, by contrast, is typical of a unilateral cortical or internal capsule stroke and presents with asymmetrical weakness. An ataxic gait points to cerebellar or dorsal column problems and is more uncoordinated and wide-based, while a waddling gait suggests proximal hip girdle weakness. So the gait most commonly observed with cervical myelopathy is spastic gait.