Cervical myelopathy mistaken for complex regional pain syndrome: A case report.

RATIONALE

Degenerative cervical myelopathy (DCM) is characterized by spastic gait impairment, upper limb dysfunction, and sphincter disturbances. The pathological mechanism involves a combination of mechanical compression and ischemic processes, which are most commonly associated with the narrowing of the vertebral canal. However, DCM requires differential diagnosis from diseases of the central nervous system that cause neuropathic pain, such as complex regional pain syndrome (CRPS) and postherpetic neuralgia.

PATIENT CONCERNS

This report presents a case of DCM misdiagnosed as CRPS. Delayed diagnosis can lead to residual symptoms and functional disability.

DIAGNOSES

Definitive diagnosis requires a correlation between physical findings and imaging results. Magnetic resonance imaging is the modality of choice, and spinal cord compression is the hallmark finding.

INTERVENTIONS

Anterior cervical discectomy and fusion.

OUTCOMES

At the 8-week postoperative follow-up, the patient reported reduced pain. Arm function was almost normal, and although the gait was unstable, he was able to walk without assistance.

LESSONS

DCM can be easily confused with CRPS or postherpetic neuralgia. Therefore, physicians should consider the presence of different neuropathic pain syndromes when neuropathic pain develops. Patients with prior conditions affecting the cervical spine should be aware of the potential development of cervical myelopathy.