Doita Minoru, Sakai Hiroshi, Harada Toshihiko, Nishida Kotaro, Miyamoto Hiroshi, Kaneko Tasuku, Kurosaka Masahiro
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Spine (Phila Pa 1976). 2006 Jun 15;31(14):1580-4. doi: 10.1097/01.brs.0000222034.78210.43.
A prospective clinical study.
To quantitatively evaluate hand function in patients with cervical myelopathy and to assess the influence of proprioceptive impairment on hand function in patients with cervical myelopathy.
Clumsiness of the hands is one of the most common complaints in patients with cervical myelopathy. However, few reports have been published that evaluate hand dysfunction, and no reports have assessed the association between hand function and proprioceptive impairment.
A total of 129 patients (36 women and 93 men) with cervical myelopathy were examined. Hand function was evaluated as scores of ten subtests designed on the basis of various hand activities. The degree of proprioceptive impairment of the hand as well as that of light touch sensation loss is classified into four grades. Scores of the hand function test are compared according to the grade of proprioceptive impairment of the hands.
Significant relation between the impairment of hand function and the extent of cervical myelopathy was observed. There was good correlation between the hand function scores and the grade of impairment of proprioception and light touch sensation. Furthermore, patients with impairment of proprioception obtained significantly lower scores in the hand function test than those with loss of light touch sensation.
The hand function test is a useful battery to objectively and quantitatively evaluate impairment of cervical myelopathy, although longitudinal studies are needed to determine its practical usability. There was some relation between scores of hand function test and the extent of proprioceptive impairment. Thus, hand function test may be partly influenced by proprioceptive loss.
一项前瞻性临床研究。
定量评估脊髓型颈椎病患者的手部功能，并评估本体感觉障碍对脊髓型颈椎病患者手部功能的影响。
手部笨拙是脊髓型颈椎病患者最常见的主诉之一。然而，很少有已发表的报告评估手部功能障碍，也没有报告评估手部功能与本体感觉障碍之间的关联。
共检查了129例脊髓型颈椎病患者（36例女性和93例男性）。根据各种手部活动设计了十个子测试，以手部功能得分进行评估。手部本体感觉障碍程度以及轻触觉丧失程度分为四个等级。根据手部本体感觉障碍等级比较手部功能测试得分。
观察到手部功能障碍与脊髓型颈椎病程度之间存在显著关系。手部功能得分与本体感觉和轻触觉丧失等级之间存在良好相关性。此外，本体感觉障碍患者在手部功能测试中的得分明显低于轻触觉丧失患者。
手部功能测试是客观定量评估脊髓型颈椎病损伤的有用组合，尽管需要纵向研究来确定其实际可用性。手部功能测试得分与本体感觉障碍程度之间存在一定关系。因此，手部功能测试可能部分受本体感觉丧失的影响。
