HOFFMANN'S SIGN OR REFLEX FOR CERVICAL SPONDYLOTIC MYELOPATHY (CSM) Next to fractures, another red flag we have to screen for in the cervical spine is cervical spondylotic myelopathy (CSM), which is an encroachment of the spinal cord at cervical level by degenerative changes (uncinate process and facet joint osteophytosis, ossification or hypertrophy of the posterior longitudinal ligament and the ligamntum flavum or subluxations of the vertebral body). If the spinal cord is compressed, our patie