A new method for characterizing hand dysfunction in cervical spondylotic myelopathy: a preliminary study.

Area of Science:

• Neuroscience
• Orthopedics
• Rehabilitation Medicine

Background:

• Cervical spondylotic myelopathy (CSM) can impair fine motor control.
• Quantitative assessment of pinch strength adjustment is crucial for understanding functional deficits in CSM.

Purpose of the Study:

• To quantitatively evaluate the ability to adjust pinch strength in patients with CSM.
• To differentiate CSM patients with and without object-dropping episodes based on pinch strength control.

Main Methods:

• A case-control study involving 19 CSM patients with frequent dropping episodes (Group A), 13 CSM patients without dropping episodes (Group B), and 16 healthy controls.
• Dynamic pinch strength measurement using a pneumatic object under conditions of minimal force (eyes open) and constant force maintenance (eyes closed).

Main Results:

• Group A demonstrated significantly higher pinch strength to prevent dropping (eyes open) and greater deviation from baseline (eyes closed) compared to Groups B and controls (P<0.01).
• These deficits in Group A correlated significantly with tactile perception thresholds but not with spasticity-related motor impairments.

Conclusions:

• The developed technique effectively assesses the functional integrity of the fasciculus cuneatus in CSM patients.
• This method provides a quantitative evaluation of proprioceptive and cutaneous feedback mechanisms in the digits, which are challenging to measure otherwise.