Which finding would be most helpful for diagnosing cervical myelopathy?

• A. Blood pressure greater than 160/95
• B. Dizziness or light-headedness related to neck movement
• C. Unexplained weight loss
• D. Abnormal gait pattern

Answer: (D)

Abnormal gait pattern signals cervical spinal cord dysfunction, which is the hallmark of cervical myelopathy. When the cervical cord is compressed, long tracts that run through the spinal cord—such as the corticospinal and dorsal columns—are affected bilaterally. This produces an UMN-type gait disturbance, often described as a spastic or ataxic gait with poor balance and leg weakness, reflecting central cord involvement rather than a localized joint or nerve root issue. Because gait changes arise from cord compression itself, they are a more direct and reliable clue to myelopathy than systemic signs (high blood pressure), vertigo or dizziness with neck movement (which point to vascular or cervicogenic phenomena), or unexplained weight loss (which is nonspecific for cord pathology). Recognizing an abnormal gait helps differentiate cervical myelopathy from other neck- or neurologic complaints and prompts appropriate imaging to confirm cord compression.