Does Spinal Cord Compression Impact Hand Function?

Cervical myelopathy, a neurological impairment caused by spinal cord compression in the cervical canal, leads to slow, progressive deterioration of neurologic function, often starting with changes in hand dexterity and coordination. Despite being often asymptomatic, it can result in intrinsic atrophy, grip and pinch weakness, small finger escape, and impaired rapid alternating movement. Misdiagnosed frequently as carpal tunnel syndrome, it requires a thorough examination and high suspicion index due to its progressive nature. Myelopathic hand, a term describing associated hand findings, includes difficulty in grip and release, motor strength loss, sensory changes, intrinsic wasting, finger escape sign, spasticity, hand dexterity loss, hyperreflexia, positive Hoffmann and Romberg signs, and gait disturbance. Various tests, such as the grip and release test, Hoffmann sign, Babinski test, and clonus test, aid in diagnosis, although their reliability varies. Ultimately, surgical treatment involving cervical spine decompression and stabilization is usually necessary as the condition rarely improves without intervention. Early diagnosis and treatment are crucial for a good outcome.