What are typical features of cervical spondylotic myelopathy?

• A. Gait disturbance with hand clumsiness and hyperreflexia
• B. Isolated radicular pain without motor signs
• C. Facial droop
• D. Sensory loss in fingertips only

Answer: (A)

Cervical spondylotic myelopathy results from degenerative changes in the cervical spine that compress the spinal cord, affecting both motor and sensory pathways. The most telling signs are upper motor neuron features below the level of compression, including a spastic gait and hyperreflexia, along with hand clumsiness from impaired fine motor control. This combination reflects disruption of the corticospinal tract and related pathways in the cord, which is the hallmark of myelopathy. By contrast, isolated radicular pain without motor signs points to a nerve root issue rather than cord compression, facial droop suggests a brainstem or facial nerve problem, and sensory loss confined to fingertips alone is not typical for myelopathy, which usually causes broader sensory or proprioceptive changes below the lesion. So the described gait disturbance with hand clumsiness and hyperreflexia best fits cervical spondylotic myelopathy.