Abstract
We reported four cases with spondylotic myelopathy at the cervicothoracic junction. They consisted of three men and one woman whose ages were 54, 62, 65 and 69 years old respectively. All cases complained of gait disturbance and MRI showed compression of the spinal cord at the C7/T1 level and high intensity lesion at the level in T2 weighted images. We investigated sensory change, hand dexterity, deep tendon reflex, pathological reflex and muscle power. All cases showed sensory disturbance below the cervical line but none complained of numbness in either arms or fingers. One case had clumsiness at the rigt hand. Deep tendon reflex of upper extremities were intact in all cases and showed hyper reflexia in the lower extremities in three cases. Hoffmann reflex was negative in all cases and Babinski reflex were positive in two cases. Two patients showed weakness of diversion of the right fingers and one showed weakness of finger flexion. These result suggested that cervicothoracic legion should be taken into account for diagnosis in patients with gait disturbance.
