A simple performance test for quantifying the severity of cervical myelopathy

Area of Science:

• Neurology
• Orthopedics
• Rehabilitation Medicine

Background:

• Cervical myelopathy is a condition affecting the spinal cord in the neck.
• Objective quantitative measures are needed for evaluating cervical myelopathy.
• Surgical decompression is a common treatment for cervical myelopathy.

Purpose of the Study:

• To evaluate the reliability of a 15-second finger grip and release test for quantifying cervical myelopathy.
• To compare the performance of patients with cervical myelopathy to healthy controls.
• To assess the effectiveness of decompressive surgery in improving finger dexterity.

Main Methods:

• 30 patients with cervical myelopathy and 42 healthy controls performed a 15-second rapid finger grip and release test.
• Video recordings were analyzed by three blinded physicians counting cycles in 5-second intervals (N1, N2, N3).
• Pre-operative and post-operative measurements were compared to controls.

Main Results:

• Pre-operative patients had significantly fewer cycles than controls (p<0.001).
• Post-operative patients showed significant improvement but still fewer cycles than controls (p<0.001).
• Controls exhibited a fatigue phenomenon (decreasing cycles over time), while pre-operative patients showed a freezing phenomenon (no significant difference between N1 and N2).

Conclusions:

• The 15-second finger test is a reliable, objective tool for quantitative evaluation of cervical myelopathy.
• The test can detect subtle neurological changes, aiding in assessing treatment efficacy.
• This method offers precise and objective neurological status assessment.