How can cervical myelopathy be differentiated from cervical radiculopathy?

• A. Presence of muscle weakness
• B. Presence of (+) Babinski
• C. Presence of pain radiation
• D. Presence of sensory loss

Answer: (B)

Cervical myelopathy and cervical radiculopathy are conditions that affect the cervical spine, but they have distinct clinical presentations. Cervical myelopathy results from spinal cord compression, while cervical radiculopathy involves nerve root compression.

The presence of a positive Babinski sign is indicative of upper motor neuron dysfunction, which is characteristic of cervical myelopathy. This sign demonstrates an abnormal reflex; when the sole of the foot is stroked, the great toe extends upward and the other toes fan out, rather than flexing. This reflexive response suggests that there is damage to the corticospinal tract, which typically occurs in conditions that affect the spinal cord, such as myelopathy.

In contrast, while muscle weakness, pain radiation, and sensory loss can occur in both conditions, they are not definitive for differentiating between the two. Muscle weakness might occur in both upper and lower motor neuron lesions, and the nature of pain is often different in radiculopathy, typically following a dermatomal pattern. Sensory loss may not be as specific as the Babinski sign in indicating the central nervous system involvement indicative of myelopathy.

Thus, the positive Babinski sign distinctly signifies more systemic neurological involvement related to cervical myelopathy, making