Cervical cord compression can arise due to a number of conditions of various origins. Neck pain, limited range of neck motion, pain in the upper extremities, severe balance difficulties, incontinence, and paralysis may be seen in cervical cord compression. A thorough neurological examination is crucial for making the initial diagnosis. Imaging studies, magnetic resonance imaging (MRI) and computed tomography (CT), are frequently necessary to identify the underlying etiology.
Cervical cord compression is a term denoting a pathological process of the cervical spinal cord in which different pathological entities cause its compression. Cervical spondylotic myelopathy (CSM), a consequence of a degenerative process of the vertebrae and surrounding connective tissue that is primarily seen in elderly persons, is one of the most frequently mentioned causes   . The clinical presentation of cervical cord compression, particularly when CSM is the underlying culprit, can have an insidious course with early symptoms being mild neck stiffness and a limited range of neck motion, reduced hand dexterity, minor balance issues, clumsiness, and difficulties with performing easy tasks (handwriting, use of keys, holding the handrail while climbing up the stairs, or text messaging)   . It is not uncommon for patients to neglect early symptoms , but as the severity of compression increases more pronounced manifestations develop. Pain in the upper extremity, particularly the shoulder, either described as stabbing or dull can appear along with hand numbness   . Paresthesias and weakness eventually arise. A more severe form of cervical cord compression leads to inadequate sphincter control and paralysis  . In rare cases, lesion of the ascending spinothalamic tract might cause referred pain to the lower back or the lower extremities termed funicular leg pain .
In order to make the diagnosis of cervical cord compression and establish the underlying cause, a comprehensive clinical approach is necessary. A properly conducted neurological examination is the crucial step for raising suspicion toward this entity    . Several findings indicative of an ongoing pathological process involving the cervical spinal cord are    :
As soon as a presumptive diagnosis is made, imaging studies must be employed. Plain radiography of the cervical spine is of limited use, which is why magnetic resonance imaging (MRI) and computed tomography (CT) are recommended    . These procedures can identify intrinsic spinal cord changes, tumors, herniated discs, skeletal abnormalities (CT is favored over MRI in this case), and determine the exact cause of the compression    .