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Trömner 征的量化:颈椎病性脊髓病的敏感标志物。

Quantification of the Trömner signs: a sensitive marker for cervical spondylotic myelopathy.

机构信息

Section of Neurorehabilitation, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Eur Spine J. 2011 Jun;20(6):923-7. doi: 10.1007/s00586-010-1681-6. Epub 2011 Jan 9.


DOI:10.1007/s00586-010-1681-6
PMID:21221662
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3099157/
Abstract

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.

摘要

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。

相似文献

[1]
Quantification of the Trömner signs: a sensitive marker for cervical spondylotic myelopathy.

Eur Spine J. 2011-1-9

[2]
The Significance of the Trömner Sign in Cervical Spondylotic Myelopathy Patient.

Clin Spine Surg. 2017-11

[3]
Quantification of Rossolimo reflexes: a sensitive marker for spondylotic myelopathy.

Spinal Cord. 2010-7-13

[4]
Magnetic resonance diffusion tensor imaging in patients with cervical spondylotic spinal cord compression: correlations between clinical and electrophysiological findings.

Spine (Phila Pa 1976). 2012-1-1

[5]
Increased spinal cord movements in cervical spondylotic myelopathy.

Spine J. 2014-10-1

[6]
[Influence of Cervical Spondylotic Spinal Cord Compression on Cerebral Cortical Adaptation. Radiological Study].

Acta Chir Orthop Traumatol Cech. 2015

[7]
Diffusion tensor imaging of somatosensory tract in cervical spondylotic myelopathy and its link with electrophysiological evaluation.

Spine J. 2014-8-1

[8]
Cervical myelopathy: a clinical and radiographic evaluation and correlation to cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2010-3-15

[9]
The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy.

Spinal Cord. 2017-4

[10]
The value of dynamic MRI in the treatment of cervical spondylotic myelopathy: a protocol for a prospective randomized clinical trial.

BMC Musculoskelet Disord. 2020-2-7

引用本文的文献

[1]
Degenerative cervical myelopathy: timing of surgery.

EFORT Open Rev. 2025-6-2

[2]
Accuracy and Reliability of Physical Signs as a Diagnostic Tool for Cervical Cord Compression: A Cross-Sectional Study.

Spine Surg Relat Res. 2024-10-29

[3]
Clinical signs and symptoms for degenerative cervical myelopathy: a scoping review of case-control studies to facilitate early diagnosis among healthcare professionals with stakeholder engagement.

Spinal Cord. 2025-3

[4]
Optimising early detection of degenerative cervical myelopathy: a systematic review of quantitative screening tools for primary care.

BMJ Neurol Open. 2025-1-11

[5]
The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy - A Systematic review and Meta-analysis.

Global Spine J. 2024-5

[6]
Prevalence and Associated Factors of Clinical Myelopathy Signs in Smartphone-Using University Students with Neck Pain.

Int J Environ Res Public Health. 2022-4-17

[7]
Ernst Trömner: beyond the reflex hammer.

Neurol Sci. 2018-9-19

[8]
Tally counter test as a simple and objective assessment of cervical myelopathy.

Eur Spine J. 2012-11-21

本文引用的文献

[1]
Cervical myelopathy: a clinical and radiographic evaluation and correlation to cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2010-3-15

[2]
Modulation of stretch reflexes of the finger flexors by sensory feedback from the proximal upper limb poststroke.

J Neurophysiol. 2009-9

[3]
Clinical correlations of cervical myelopathy and the Hoffmann sign.

J Neurosurg Spine. 2008-9

[4]
The spinal pathophysiology of spasticity--from a basic science point of view.

Acta Physiol (Oxf). 2007-2

[5]
Neurological manifestations of cervical spondylosis: an overview of signs, symptoms, and pathophysiology.

Neurosurgery. 2007-1

[6]
Fingertip injuries.

Clin Occup Environ Med. 2006

[7]
Changes in the excitability of the H-reflex in wrist flexors related to the prone or supine position of the forearm in man.

Neurosci Lett. 2000-12-8

[8]
From spinal shock to spasticity: neuronal adaptations to a spinal cord injury.

Neurology. 2000-4-25

[9]
Cervical spondylotic myelopathy: a review of surgical indications and decision making.

Yale J Biol Med. 1993

[10]
[The Trömner reflex: a continuing misunderstanding?].

Nervenarzt. 1987-1

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