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Cervical spondylotic myelopathy combined with overshunting-associated myelopathy: Two case reports

Year: 2026

Type: article

Abstract: Background Distinguishing cervical spondylotic myelopathy from overshunting-associated myelopathy in patients with ventricular shunts is difficult because their clinical and imaging findings overlap. Case presentation Case 1 was a 68-year-old woman who underwent laminoplasty for presumed cervical spondylotic myelopathy before cerebrospinal fluid overdrainage was recognized. Postoperative neurological deterioration was associated with a serous epidural effusion, and her symptoms improved after shunt-pressure adjustment. Case 2 was a 77-year-old man in whom overshunting-associated myelopathy was suspected preoperatively. Shunt adjustment partially improved his symptoms, but persistent compression required laminoplasty, resulting in favorable recovery. Conclusions Patients with ventricular shunts who present with cervical myelopathy should be evaluated for cerebrospinal fluid overdrainage before decompressive spinal surgery. Shunt assessment and pressure adjustment may prevent unnecessary intervention and reduce postoperative complications.

Source: JOS Case Reports

DOI: 10.1016/j.joscr.2026.09.001