Department of Orthopaedic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Spine J. 2011 Apr;11(4):270-80. doi: 10.1016/j.spinee.2011.02.003.
In animal studies, distal and proximal arm movements are differently affected by spinal pyramidotomy because of the contributions of spinal interneuronal systems. In animals, interneuronal systems are also suggested to contribute to the recovery of dexterous hand movements. However, no clinical tests to evaluate proximal arm movements and functions of interneuronal systems have been described.
To compare parameters from proximal arm movements between patients and controls and in patients before and after decompression surgery.
A cross-sectional and longitudinal study performed at Kyorin University School of Medicine, Japan.
Patients with clinical features of cervical spondylotic myelopathy, without coexisting neurological abnormality.
Twenty-eight patients and 15 age-matched controls performed reach-to-touch movements. Analysis of these movements identified several parameters, including time for online correction (correction time) induced by sudden target jump. Parameters were compared with scores from conventional tests, such as Japanese Orthopedic Association (JOA) score, 10-second grip-and-release test, manual muscle testing, and motor-evoked potential.
Preoperatively, patients showed long correction time and variable touch position, neither of which correlated with any scores from conventional tests. Reaching parameters recovered markedly immediately after decompression surgery, whereas conventional scores, which mainly assess hand functions, recovered much more slowly. Correction time and JOA score showed correlations when postoperative data were included, and long-term recovery of JOA score was more predictable with the inclusion of data for correction times from before and immediately after surgery.
Analysis of arm movements is useful to evaluate symptoms and predict recovery of hand functions after surgery in patients with cervical myelopathy. These results suggest the importance of interneuronal systems, in addition to the pyramidal tract, for motor control even in humans.
在动物研究中，由于脊髓中间神经元系统的作用，远端和近端手臂运动受到不同程度的影响。在动物中，中间神经元系统也被认为有助于灵巧手部运动的恢复。然而，目前还没有评估近端手臂运动和中间神经元系统功能的临床测试。
比较患者与对照组、患者手术前后近端手臂运动的参数。
在日本桐荫医疗大学进行的一项横断面和纵向研究。
具有颈椎病脊髓病临床特征，无并存神经功能异常的患者。
28 名患者和 15 名年龄匹配的对照组进行触及触摸运动。对这些运动的分析确定了几个参数，包括由突然目标跳跃引起的在线校正（校正时间）时间。将参数与常规测试的评分进行比较，如日本骨科协会（JOA）评分、10 秒握放测试、徒手肌力测试和运动诱发电位。
术前，患者的校正时间长，触诊位置变化，两者均与常规测试的任何评分均无相关性。减压手术后，立即明显恢复了接近参数，而主要评估手部功能的常规评分恢复速度要慢得多。包括术后数据后，校正时间和 JOA 评分之间存在相关性，包括术前和术后立即的校正时间数据，更能预测 JOA 评分的长期恢复。
手臂运动分析有助于评估颈椎病患者术后手部功能的症状和预测恢复。这些结果表明，即使在人类中，除了锥体束外，中间神经元系统对运动控制也很重要。
