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Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy
Asian Spine Journal ; : 65-69, 2016.
Article in English | WPRIM | ID: wpr-28512
ABSTRACT
STUDY

DESIGN:

This was a retrospective study.

PURPOSE:

The purpose of this study was to study the relationship between prevalence of pyramidal signs and the severity of cervical myelopathy. The study is focused on patients having increased signal intensity in T2-weighted magnetic resonance imaging. OVERVIEW OF LITERATURE Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in elderly population. It is the consequence of spondylotic changes leading to cervical cord injury with resulting clinical deficits. Diagnosis in such patients is made based on clinical and radiographic features. A patient must have both symptoms and signs consistent with cervical cord injury as well as radiographic evidence of damage to spondylotic cord.

METHODS:

Forty-six patients with complaint of cervical spondylotic myelopathy with increased signal intensity in T2-weighted magnetic resonance imaging were included in the study. The neurological finding of the patients was reviewed for the presence of pyramidal signs. The prevalence of each pyramidal sign was calculated and correlated to severity of cervical myelopathy. The motor function scores of the upper and lower extremities for cervical myelopathy set by the Japanese Orthopedic Association (motor Japanese Orthopaedic Association score, m-JOA) scores were used to assess severity of myelopathy.

RESULTS:

The most prevalent signs were hyperreflexia (89.1%), Hoffmann reflex (80.4%), Babiniski sign (56.5%), and ankle clonus (39.1%). Babiniski sign, ankle clonus, and Hoffmann reflex showed significant association with the lower m-JOA score.

CONCLUSIONS:

In patients with cervical myelopathy, hyperreflexia exhibited highest sensitivity whereas ankle clonus demonstrated lowest sensitivity. The prevalence of the pyramidal signs is correlated with increasing severity of myelopathy.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Orthopedics / Reflex / Spinal Cord / Spinal Cord Diseases / Magnetic Resonance Imaging / Reflex, Abnormal / Prevalence / Retrospective Studies / Lower Extremity / Asian People Type of study: Diagnostic study / Observational study / Prevalence study Limits: Aged / Humans Language: English Journal: Asian Spine Journal Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Orthopedics / Reflex / Spinal Cord / Spinal Cord Diseases / Magnetic Resonance Imaging / Reflex, Abnormal / Prevalence / Retrospective Studies / Lower Extremity / Asian People Type of study: Diagnostic study / Observational study / Prevalence study Limits: Aged / Humans Language: English Journal: Asian Spine Journal Year: 2016 Type: Article