Ver Mikhail Lew Perez, Gum Jeffrey L, Glassman Steven D, Carreon Leah Y
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, United States of America.
N Am Spine Soc J. 2020 Sep 8;3:100023. doi: 10.1016/j.xnsj.2020.100023. eCollection 2020 Oct.
The Romberg test is used to identify balance issues in patients with Cervical Spondylotic Myelopathy (CSM), but has subjective interpretation. The purpose of this study is to evaluate force plate pressure readings during a Romberg test to quantify postural control.
Quantitative Romberg force plate readings with eyes open and closed in patients with CSM were obtained and changes in balance measurements were compared to a normal population ( = 28, mean age 39 ± 7 years).
We identified 30 CSM patients with a mean age of 58 ± 10 years. Majority of patients presented with pain (90%) and neurologic symptoms (83%). Cord compression on imaging was identified in 90%. Mean eyes closed Romberg measurements were larger compared to eyes open measurements in CSM patients ( < 0.01). There was a larger change in Romberg (∆R) measurements in CSM compared to normals for total sway area (TSA, 14.18 vs 0.02 cm, < 0.001) and average speed (AS, 2.07 vs 0.23 cm/s, < 0.001). The presence of long tract signs produced larger ∆R (TSA, 15.35 vs 0.02 cm, = 0.003; AS, 2.21 vs 0.23 cm/s, = 0.001), and those with identified cord compression on imaging also had larger ∆R (TSA, 15.1 vs 0.02 cm, < 0.001; AS, 2.17 vs 0.23 cm/s, < 0.001).
Standing balance can be quantified in patients with CSM and is worse when compared to a normal population. Long tract signs and cord compression in imaging translates to worse balance in myelopathic patients. The use of quantitative Romberg measurements help evaluate balance in CSM.
罗姆伯格试验用于识别脊髓型颈椎病（CSM）患者的平衡问题，但存在主观解读。本研究的目的是评估罗姆伯格试验期间测力板压力读数，以量化姿势控制。
获取CSM患者睁眼和闭眼时的定量罗姆伯格测力板读数，并将平衡测量的变化与正常人群（n = 28，平均年龄39±7岁）进行比较。
我们纳入了30例平均年龄为58±10岁的CSM患者。大多数患者有疼痛（90%）和神经症状（83%）。90%的患者影像学检查发现脊髓受压。与睁眼测量相比，CSM患者闭眼时的平均罗姆伯格测量值更大（P < 0.01）。与正常人相比，CSM患者的罗姆伯格（∆R）测量值在总摆动面积（TSA，14.18 vs 0.02 cm，P < 0.001）和平均速度（AS，2.07 vs 0.23 cm/s，P < 0.001）方面变化更大。存在长束征时∆R更大（TSA，15.35 vs 0.02 cm，P = 0.003；AS，2.21 vs 0.23 cm/s，P = 0.001），影像学检查发现脊髓受压的患者∆R也更大（TSA，15.1 vs 0.02 cm，P < 0.001；AS，2.17 vs 0.23 cm/s，P < 0.001）。
CSM患者的站立平衡可以量化，与正常人群相比更差。影像学检查中的长束征和脊髓受压表明脊髓型患者的平衡更差。使用定量罗姆伯格测量有助于评估CSM患者的平衡。
