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Cervical spondylotic disease is the most common cause of myelopathy in patients over the age of 55 years and accounts for 25% of all hospitalizations for spastic quadriparesis.
It can be confused with lumbar spine disease as the most common presentation is a slowly progressive spastic gait dysfunction with 15-20% presenting with bladder disturbance.
Take Home Message: Don’t rush to localizing a lesion to the lumbar spine without performing a thorough neuro exam.
References
Gorter K. Influence of laminectomy on the course of cervical myelopathy. Acta Neurochir (Wien) 1976;33(3Y4):265-281