Kirill Alekseyev, Samuel Thampi, Nnabugo Ozurumba, Jaison Udani and Malcolm Lakdawala
A 70-year-old African American woman presented to the pain management clinic with complaints of lower back pain and bilateral calf pain with weakness in her legs. The clinical impression was lumbar radiculopathy. MRI of the low back revealed disc bulges which could not explain all the weakness in her legs. Hoffman’s sign was positive which prompted us to image the cervical spine which revealed cervical myelopathy. This case highlights the importance of silent cervical myelopathic presenting without neck pain, in patients with low back pain.