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Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy
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....
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Spine Surgery
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764543/ https://www.ncbi.nlm.nih.gov/pubmed/26949460 http://dx.doi.org/10.4184/asj.2016.10.1.65 |
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author | Elnoamany, Hossam |
author_facet | Elnoamany, Hossam |
author_sort | Elnoamany, Hossam |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4764543 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-47645432016-03-06 Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy Elnoamany, Hossam Asian Spine J Clinical Study 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. Korean Society of Spine Surgery 2016-02 2016-02-16 /pmc/articles/PMC4764543/ /pubmed/26949460 http://dx.doi.org/10.4184/asj.2016.10.1.65 Text en Copyright © 2016 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Elnoamany, Hossam Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title | Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title_full | Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title_fullStr | Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title_full_unstemmed | Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title_short | Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy |
title_sort | sensitivity of pyramidal signs in patients with cervical spondylotic myelopathy |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764543/ https://www.ncbi.nlm.nih.gov/pubmed/26949460 http://dx.doi.org/10.4184/asj.2016.10.1.65 |
work_keys_str_mv | AT elnoamanyhossam sensitivityofpyramidalsignsinpatientswithcervicalspondyloticmyelopathy |