Dissociated micturitional disturbance in a patient with cervical spondylotic myelopathy

A 58-year-old man developed dysuria and residual sensation one year after the traffic accident. Half a year later, he developed chest pain and underwent coronary arteriography. Numbness in the left arm, burning sensation below the knees and urinary retention emerged immediately after prolonged neck extention during the examination. He required intermittent catheterization of the bladder because of persistent dysuria. Urodynamic study revealed detrusor-sphincter dyssynergia. The micturitional disturbance improved with the application of a soft cervical collar and a bed rest. MRI of the cervical spine showed spinal cord compression at the C5/6 and a small hyperintensity area on T2WI in the spinal cord at the C5 level. The case suggests that micturitional dysfunction can be severe without remarkable sensorimotor disturbances of the lower extremities in cervical spondylotic myelopathy.