Presentation and management of a patient with rapid progression of degenerative cervical myelopathy during pregnancy: a case report.

OBJECTIVE

To describe the clinical presentation and management of a patient with degenerative cervical myelopathy (DCM) during pregnancy.

CASE PRESENTATION: A 34-year-old female, who was 21-weeks pregnant, presented for chiropractic evaluation with acute left upper-back pain.

INTERVENTION AND OUTCOME: For the initial symptoms, the patient completed multidisciplinary treatment with progressive improvement in pain. At the nine-week follow-up visit, the patient described a rapid onset of extremity paresthesia and balance change. The physical examination revealed hyperreflexia. DCM was established as the working diagnosis based on clinical examination. Spinal cord compression was confirmed by MRI (magnetic resonance imaging). The patient had a cesarean delivery and anterior cervical discectomy and fusion (ACDF) surgery was performed at four-weeks postpartum.

SUMMARY: Symptoms associated with DCM may be wide-ranging. DCM diagnosis is commonly delayed and timely recognition and management is essential. This case highlights the importance of awareness of DCM and appropriate management for this condition.