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compression of the spinal cord and the hand function cervical myelopathy is a form of neurologic impairment due to compression of the spinal cord in the cervical canal mri is usually the study of choice to diagnose cervical myelopathy the natural history of cervical myelopathy is slow stepwise deterioration over time with variable periods of stable neurologic function changes in hand dexterity and coordination are among the earliest signs and these may be present in otherwise asymptomatic individuals the progressive cervical cord compression can result in intrinsic atrophy weakness in grip and pinch small finger escape impaired ability to perform rapid alternating movement thorough history and physical exam is important given the often asymptomatic but progressive nature of cervical myelopathy the lower cervical nerve roots c8t1 are the most severely affected the clinical presentation of myelopathy is highly variable the typical patient with cervical myelopathy will complain of symmetr