Which finding is part of the cervical spine myelopathy cluster described by Cook et al.?

• A. Ataxia
• B. Numbness in fingertips
• C. Decreased reflexes
• D. Nocturnal neck pain

Answer: (A)

Cervical myelopathy involves the spinal cord and produces upper motor neuron–type signs that affect gait and coordination. In the Cook et al. cluster, gait disturbance or ataxia reflects disruption of proprioception and corticospinal pathways from cord compression, making ataxia the finding that best fits a cord-based process. Numbness in the fingertips can occur with peripheral nerve or dermatomal issues rather than a cord syndrome, and decreased reflexes are more typical of lower motor neuron or radicular problems (or early spinal shock) rather than the classic UMN pattern seen with myelopathy. Nocturnal neck pain is non-specific and not a defining feature of the cord-based cluster.