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颈椎脊髓压迫症 Hoffmann 征与神经影像学表现的临床相关性研究。

A Clinical Correlation Research of the Hoffmann Sign and Neurological Imaging Findings in Cervical Spinal Cord Compression.

机构信息

Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

World Neurosurg. 2019 Aug;128:e782-e786. doi: 10.1016/j.wneu.2019.04.254. Epub 2019 May 9.

Abstract

BACKGROUND

The Hoffmann sign is usually used as an indicator of upper motor neuron lesion, but its clinical effect remains controversial in previous reports.

METHODS

A retrospective case control study including 107 patients with cervical complaints was carried out. According to the presence of Hoffmann sign, patients were divided into 2 groups. The radiographic results were assessed and the sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology, segment, cervical spine canal ratio, and S-index were calculated.

RESULTS

There were 56 patients in the positive Hoffmann group and 51 patients in negative group. The sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology were found to be 61.6%, 85.7%, 94.6%, 35.3%, 14.3%, 38.4% and 60.5%, 81.0%, 92.9%, 33.3%, 19.0%, 39.5%, respectively. The ratio of cervical spine canal was lower in the positive Hoffmann group than in control group.

CONCLUSIONS

Although the Hoffmann sign is not foolproof in the diagnosis of cervical spinal cord compression, it can be used to assess symptomatic patients. The narrower the cervical spine canal or the higher the cervical segment compression, the higher of the incidence of positive Hoffmann sign.

摘要

背景

霍夫曼征通常被用作上运动神经元损伤的指标,但在之前的报道中其临床效果仍存在争议。

方法

对 107 例颈痛患者进行回顾性病例对照研究。根据霍夫曼征的存在,将患者分为 2 组。评估影像学结果,并计算霍夫曼征对颈椎病变、节段、颈椎管比值和 S 指数的敏感性、特异性、阳性和阴性预测值以及假阳性和假阴性值。

结果

阳性霍夫曼征组有 56 例,阴性组有 51 例。霍夫曼征对颈椎病变的敏感性、特异性、阳性和阴性预测值以及假阳性和假阴性值分别为 61.6%、85.7%、94.6%、35.3%、14.3%和 38.4%和 60.5%、81.0%、92.9%、33.3%、19.0%、39.5%。阳性霍夫曼征组的颈椎管比值低于对照组。

结论

尽管霍夫曼征在诊断颈椎脊髓压迫症时并非万无一失,但它可以用于评估有症状的患者。颈椎管越窄或颈椎节段受压越高,阳性霍夫曼征的发生率越高。

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