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July 11, 1977

Hemiparesis and Cervical Spondylosis-Reply

JAMA. 1977;238(2):127. doi:10.1001/jama.1977.03280020030007

To the Editor.—  In regard to the article by Wallack et al, two observations were noticed:

  1. It might have been very interesting to compare their results with those of Gregorius and his associates.1 The two patients presented would probably have fit in their myelopathy group. In this group of patients, more than 60% had symptoms of upper extremity weakness; 80% had symptoms of lower extremity weakness; 60% had spasticity in the upper extremity; more than 80% had spasticity in the lower extremity; and nearly all had gait disturbance. A "worsened disability" was noted in this group of patients after operation.

  2. Electromyography would have been very useful, particularly in the first case. An electromyogram would have shown evidence of radiculopathy. Although positive sharp waves and fibrillation potentials have been noted in stroke patients, these follow a sequence of regression so that, for example, these would probably not be