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Related Experiment Videos

Cervical spinal cord compression and the Hoffmann sign.

J A Glaser1, J K Curé, K L Bailey

  • 1Department of Orthopaedic Surgery, Medical University of South Carolina, USA.

The Iowa Orthopaedic Journal
|January 30, 2002
PubMed
Summary

The Hoffmann sign is not a reliable indicator for cervical spinal cord compression. This study found its predictive values to be insufficient for clinical use without other supporting evidence.

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Area of Science:

  • Neurology
  • Orthopedics
  • Spinal Surgery

Background:

  • Cervical spinal cord compression requires accurate diagnostic methods.
  • The Hoffmann sign is a clinical test with limited established utility in diagnosing cervical spinal cord compression.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of the Hoffmann sign in predicting cervical spinal cord compression.
  • To determine the sensitivity, specificity, and predictive values of the Hoffmann sign.

Main Methods:

  • A consecutive series of patients with cervical spine complaints were assessed.
  • The Hoffmann sign was elicited, and imaging studies were reviewed for cervical spinal cord compression.
  • Compression was defined by specific imaging criteria including cord flattening and CSF obliteration.

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Main Results:

  • The spine surgeon's review showed a sensitivity of 58% and specificity of 78% for the Hoffmann sign.
  • A blinded neuroradiologist review yielded lower sensitivity (33%) and specificity (59%).
  • Positive predictive values were 62% (surgeon) and 26% (neuroradiologist), and negative predictive values were 75% (surgeon) and 67% (neuroradiologist).

Conclusions:

  • The Hoffmann sign, as a standalone test, demonstrates insufficient reliability for screening cervical spinal cord compression.
  • Clinical correlation with other findings is essential when considering the Hoffmann sign in patient evaluation.
  • Further research may be needed to clarify the role, if any, of the Hoffmann sign in specific clinical contexts.