| Myelopathy hand: new evidence of the classical sign. | |
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MedLine Citation:
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PMID: 20354474 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Motion analysis on video files that captured grip and release cycles with fingers. OBJECTIVE: To reveal the kinematic characteristics of finger motion in cervical myelopathy. SUMMARY OF BACKGROUND DATA: Myelopathy patients are often unable to smoothly move their fingers in grip and release cycles. Although paradoxical wrist motion (trick motion) and lack of finger coordination are well-known phenomena in myelopathy patients, it is not known which types of myelopathy patients present with these kinematic characteristics, and it is not known why they occur. METHODS: Thirty patients with myelopathy were evaluated before and after decompressive surgery and compared with 42 healthy controls. The subjects were asked to grip and release with their fingers as rapidly as possible for 15 seconds. Movies taken with a digital camera were divided into 3 animation files of 5-seconds each. Three physicians independently counted the number of finger grip and release cycles of those files in a blinded manner; they also evaluated trick motion of the wrist and lack of finger coordination. RESULTS: Both the frequency of trick motion and that of uncoordinated finger motion were significantly higher in the preoperative myelopathy group than in the control group (trick motion, 11.7% vs. 4.8% and uncoordinated finger motion, 15.6% vs. 7.1%), but were the same in the pre- and postoperative myelopathy groups. In the preoperative myelopathy group, the number of grip and release cycles of uncoordinated finger motion files, especially ulnar delay type, was significantly smaller than that of coordinated finger motion files, which meant uncoordinated finger motion was related to the severity of myelopathy. CONCLUSION: Both uncoordinated finger motion and trick motion of the wrist were more frequent in myelopathy patients than in healthy controls, and uncoordinated finger motion was associated with severity of myelopathy, whereas trick motion was not associated with either severity of myelopathy or level of cord compression. These findings contradict the conventional idea that trick motion is associated with the severity of myelopathy. |
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Authors:
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Noboru Hosono; Takahiro Makino; Hironobu Sakaura; Yoshihiro Mukai; Takeshi Fuji; Hideki Yoshikawa |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-16 Completed Date: 2010-07-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: E273-7 Citation Subset: IM |
Affiliation:
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Department of Orthopedic Surgery, Osaka Kosei-Nenkin Hospital, Fukushima, Osaka, Japan. hosono-n@umin.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers Decompression, Surgical Disability Evaluation* Female Fingers / innervation, physiopathology Hand / innervation*, physiopathology Hand Strength / physiology* Humans Male Middle Aged Motor Skills / physiology Movement Disorders / diagnosis*, etiology, physiopathology Muscle, Skeletal / innervation, physiopathology Neurologic Examination / methods Neurosurgical Procedures Outcome Assessment (Health Care) Peripheral Nerves / physiopathology Predictive Value of Tests Prognosis Spinal Cord / physiopathology Spinal Cord Compression / complications, diagnosis*, physiopathology Spinal Nerve Roots / physiopathology Spondylosis / complications, diagnosis*, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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