Screening for Cervical Myelopathy

Nxt Gen PT Evidence: Medical screening is one of the most important aspects of clinical care. We must determine who is appropriate for our interventions and who would benefit from a referral.

One condition that we need to screen for is cervical myelopathy. Individuals with cervical myelopathy typically present with a cluster of upper motor neuron signs such as:

Unsteady gait
Reflexes > 2+
Hoffmann’s Sign: Tap the nail of the 3rd or 4th digit with the thumb and index finger relaxed but not touching. A + test is involuntary flexing of the thumb and index finger.
Babinski Sign: a blunt instrument is rubbed along the lateral aspect of the heel to the toes. A + test is dorsiflexion of the big toe and fanning of the other toes.
wasting of the hands, loss of dexterity, nonspecific weakness

If a patient presents with signs and symptoms of cervical myelopathy, it is important to refer to a physician for further assessment. MRI, CT scan or myelography is necessary for confirmation.

Brought to you by Nxt Gen PT Institute of PT

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...