CERVICAL SPONDYLOTIC AMYOTROPHY - MAGNETIC-RESONANCE-IMAGING DEMONSTRATION OF INTRINSIC CORD PATHOLOGY

Study Design. Three case reports. Objective. To elucidate the pathophy siology of cervical spondylotic amyotrophy. Summary of Background Data . Cervical spondylotic amyotrophy is the clinical syndrome in cervical spondylosis characterized by severe muscular atrophy in the upper ext remities, with an absent or insignificant sensory deficit. Pathophysio logy of this particular syndrome has not been well understood. Methods . Three cases of cervical spondylotic amyotrophy are presented in whic h magnetic resonance imaging confirmed the intrinsic cord disease as t he cause bf the syndrome. Results. The patients had segmental muscular atrophy of the proximal upper extremities, with an absent ; or insign ificant sensory deficit. After: initial:disease progression;:the sympt oms stabilized for years. Sagittal T2-weighted magnetic resonance imag es showed multi-segmental linear high-signal intensity within the comp ressed spinal cord. These high-signal intensity lesions appeared to be located at the anterior horns on axial images. The spinal cord compre ssion was less severe in the neck-neutral position, but spinal canal S tenosis increased when the neck was extended. Conclusions. The results suggest that one pathophysiology: of this syndrome may be multisegmen tal damage to the anterior horns caused by dynamic cord compression, p ossibly through circulatory insufficiency.