Résumé
Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.
Résumé
Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.
Résumé
Objective To discuss the clinical efficacy of early surgical intervention of acute incomplete cervical spinal cord injury and the selection of operative modes. Methods The clinical data of 462 patients incomplete cervical spinal cord injury, who were treated in our hospital from January 2003 to May 2014 were analyzed retrospectively. There were 387 cases in the operation group (283 received anterior cervical decompression and bone graft fusion and internal fixation, 26 received anterior and posterior decompression, and 78 received simple posterior decompression) and 75 cases in non-operative group. The neurological function recovery of cervical spinal cord injury was evaluated by Frankel classification and ASIA scoring criteria. Results The patients were followed up for 12-27 months. The results showed that the Frankel classification was improved to different degrees in 432 cases, with an improvement rate of 93.51%. The improvement rate of operative treatment group was 98.45%, which was higher than that of the non-operative group (68.00%). The ASIA scores of both groups were increased after treatment (P<0.05), and the increase in the operation group was greater than the non-operation group (P<0.05). In addition, the ASIA improvement of the anterior and anterior plus posterior approach surgery was greater than that of the simple posterior approach surgery (P<0.05). Conclusion Early surgical intervention should be given to acute incomplete cervical spinal cord injury so as to promote the neuronal function recovery.