MRCP2-3018

A 55-year-old man presents with tingling in his left upper limb that originated in his neck and radiated down his left arm. He also experienced numbness and paraesthesia in his left lower limb. Upon examination, there was a restriction of neck movements and mild wasting in his left biceps. Inversion of the supinator and biceps jerks were noted, along with hyperreactive knee and ankle jerks and a positive extensor plantar response. A diagnosis of cord compression was made, and he underwent surgical decompression. However, post-surgery was complicated by septicaemia and urinary tract infection, and he remained bedridden for four days. Subsequently, he developed an inability to dorsiflex his right foot and right big toe, along with numbness on the outside of his foot and decreased eversion (but normal inversion). His reflexes remained unchanged. What is the cause of his postoperative weakness?