Patel PR, Swanson RL, Caldera FE. Subacute Combined Degeneration Masking Spinal Stenosis: A Case Report.
Cureus 2023;
15:e36367. [PMID:
37082480 PMCID:
PMC10110411 DOI:
10.7759/cureus.36367]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/20/2023] Open
Abstract
Subacute combined degeneration (SCD) from vitamin B12 deficiency and spinal stenosis from degenerative changes may present similarly with weakness, sensory disturbances, and ataxia but require different treatments. This case report describes a 74-year-old male with suspected SCD who was discharged to an inpatient rehabilitation facility (IRF), did not improve with B12 supplementation, and later developed signs of myelopathy and diffuse joint pain. He ultimately was found to have severe cervical stenosis and pseudogout that were treated with a laminectomy and colchicine, respectively. Following surgical intervention, he returned to the IRF, where he had considerable functional improvement and was safely discharged home. This report shows the importance of recognizing the two conditions, their overlap, and the contrast between Occam's razor and Hickam's dictum.
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