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  • Title: Wrist drop and muscle weakness of the fingers induced by an upper cervical spine anomaly.
    Author: Tsunoda D, Iizuka H, Iizuka Y, Nishinome M, Takagishi K.
    Journal: Eur Spine J; 2014 May; 23 Suppl 2():218-21. PubMed ID: 24057282.
    Abstract:
    PURPOSE: This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly. METHODS: A 77-year-old male complained of severe muscle weakness of the right hand. Cervical spine MRI showed a severe and sharp compression of the spinal cord from the dorsal side between C2 and C3 with intramedullary intensity changes and mild stenosis at C3/4 and C4/5. RESULTS: The patient underwent laminectomy of C2, cranial side laminotomy of C3, and laminectomy of C4. Decompression of the spinal cord was demonstrated 1 year after surgery. The patient achieved full recovery of the muscle weakness 1 year after undergoing surgery. CONCLUSIONS: The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
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