Section of Neurorehabilitation, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Eur Spine J. 2011 Jun;20(6):923-7. doi: 10.1007/s00586-010-1681-6. Epub 2011 Jan 9.
The Trömner sign is commonly used as a clinical neurological examination for upper motor neuron lesions above the fifth or sixth cervical segments of the spinal cord. This study aims to assess and quantify the Trömner signs utilizing electrophysiological test, and correlate to the severity of cord compression in cervical spondylotic myelopathy (CSM). We enlisted 46 CSM patients, and 30 healthy persons as controls. Manual Trömner and Hoffmann signs were tested in all subjects. By using a self-designed instrument, we performed electrophysiological assessments for the Trömner signs in patients and controls. Parameters of conduction latencies and amplitude of muscle action potentials were measured and compared with the cord compression ratios in CSM patients. The results showed a greater diagnostic sensitivity for the quantified Trömner signs in comparison to those of manual Trömner signs and Hoffmann signs. We found a positive correlation between the amplitude of muscle action potentials obtained in the Trömner signs and the cord compression ratios in the patients with CSM. In conclusion, the Trömner signs can be measured by electrophysiological assessments. We demonstrate a new quantification method for an established neurological sign. Not only is Trömner sign a highly sensitive test in clinical neurological examination, the electrophysiological assessment of this sign can also serve as an objective marker for evaluation of the severity of cervical cord compression.
特罗默征通常用于检查第五或第六颈椎以上脊髓的上运动神经元病变的临床神经学检查。本研究旨在利用电生理测试评估和量化特罗默征,并与颈椎病性脊髓病(CSM)的脊髓压迫严重程度相关联。我们招募了 46 名 CSM 患者和 30 名健康人作为对照。所有受试者均接受了手动特罗默征和霍夫曼征测试。我们使用自行设计的仪器对患者和对照组的特罗默征进行了电生理评估。测量了传导潜伏期和肌肉动作电位幅度等参数,并与 CSM 患者的脊髓压迫比进行了比较。结果表明,量化后的特罗默征比手动特罗默征和霍夫曼征具有更高的诊断敏感性。我们发现,CSM 患者特罗默征中的肌肉动作电位幅度与脊髓压迫比呈正相关。总之,特罗默征可以通过电生理评估来测量。我们展示了一种新的量化方法来评估这个已建立的神经学征。特罗默征不仅是临床神经学检查中高度敏感的测试,该征的电生理评估也可以作为评估颈椎脊髓压迫严重程度的客观标志物。
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