Rationale: Cervical spondylotic myelopathy (CSM) is the most common spinal cord disorder in older patients. The purpose of this case report is to introduce conservative treatment with integrative Korean medicine (KM) as a possible alternative to surgery in patients with mild CSM.
Patient concerns: An 81-year-old male with both hand weakness and dysesthesia was diagnosed with CSM and was recommended laminectomy. However, considering the patient's age and the underlying disease, he refused immediate surgery and preferred KM treatment DIAGNOSES:: The diagnosis of mild CSM was based on a modified Japanese Orthopedic Association (mJOA) score as well as the presence of compression on the spinal cord in magnetic resonance imaging findings INTERVENTIONS:: Integrative KM treatment consisting of acupuncture, acupotomy, Bee venom herbal acupuncture, cupping therapy, moxibustion, and herbal medicine was provided during the 12-week admission.
Outcomes: Clinical improvement was detected with a mJOA score (11 to 17), a numerical rating scale for dysesthesia intensity (5 to 2), finger escape sign (+/+ to +/-), grip and release test (11/14 to 32/31) and grasp power measured by dynamometer (3.1/9.7 to 10.8/18.3 kg) at 12 weeks. This improvement was maintained without surgery until 1 year.
Lessons: This case suggests that integrative KM was a possible conservative management option for mild CSM.