Department of Orthopedic Surgery, Osaka Kosei-Nenkin Hospital, Fukushima, Osaka, Japan.
Spine (Phila Pa 1976). 2010 Apr 15;35(8):E273-7. doi: 10.1097/BRS.0b013e3181c6afeb.
Motion analysis on video files that captured grip and release cycles with fingers.
To reveal the kinematic characteristics of finger motion in cervical myelopathy.
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.
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.
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.
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.
对视频文件中的手指抓握和释放周期进行运动分析。
揭示颈椎病患者手指运动的运动学特征。
颈椎病患者通常无法在抓握和释放周期中流畅地移动手指。尽管腕部反常运动（巧动）和手指协调性缺乏是颈椎病患者众所周知的现象，但尚不清楚哪些类型的颈椎病患者具有这些运动学特征，也不知道为什么会出现这些特征。
对 30 例颈椎病患者术前和术后进行评估，并与 42 例健康对照组进行比较。要求患者尽可能快地用手指抓握和释放 15 秒。使用数码相机拍摄的电影被分为 3 个 5 秒的动画文件。三位医生以盲法独立计数这些文件中手指抓握和释放的周期数；他们还评估了腕部的巧动和手指协调性缺乏。
术前颈椎病组的巧动和手指不协调运动的频率明显高于对照组（巧动，11.7%比 4.8%和手指不协调运动，15.6%比 7.1%），但术前和术后颈椎病组的频率相同。在术前颈椎病组中，不协调手指运动文件的抓握和释放次数，尤其是尺侧延迟型，明显小于协调手指运动文件，这意味着不协调手指运动与颈椎病的严重程度有关。
与健康对照组相比，颈椎病患者的不协调手指运动和腕部巧动更为频繁，不协调手指运动与颈椎病的严重程度相关，而巧动与颈椎病的严重程度或脊髓压迫程度无关。这些发现与巧动与颈椎病严重程度相关的传统观念相矛盾。
