Curt Armin, Zipser Carl Moritz
Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
Eur J Neurol. 2025 Jan;32(1):e16556. doi: 10.1111/ene.16556. Epub 2024 Nov 27.
In 1916, Hans H. G. Queckenstedt (1876-1918) was the first to describe a test aimed at detecting spinal cerebrospinal fluid (CSF) space obstruction through lumbar CSF pressure measurements in paraplegic patients. For this test, bilateral jugular vein compression was applied during lumbar puncture and consecutive changes in lumbar CSF pressure were then observed. Findings were rated as normal, or indicative of incomplete or complete spinal block. This test, known as Queckenstedt's test, became widely adopted and further developed in the field.
This systematic literature review provides an overview of the milestones in research using Queckenstedt's test.
Clinical research involving Queckenstedt's test was widely disseminated across the globe. In 1922, the proof of concept for Queckenstedt's test was provided by James B. Ayer (1882-1963) through simultaneous cisternal and lumbar CSF pressure measurements. He found that the cisternal (in contrast to lumbar) pressure remained responsive in cases with spinal block. The test was further refined up until the 1960s, and was considered a routine diagnostic procedure for testing of spinal canal obstruction. Developments in non-invasive spinal computed tomography and magnetic resonance imaging led to a significant decline in interest in Queckenstedt's test, and the test eventually disappeared from textbooks and clinical routine. However, at the beginning of the 21st century there was renewed interest in revealing the biomechanical properties of the CSF through advanced recording and computational techniques to complement spinal imaging.
Spine and spinal cord physicians should be familiar with Queckenstedt's test, which not only represented a milestone in spinal diagnostics, but provided a physiological framework for the appreciation of spinal cord compression that is still valid today.
1916年，汉斯·H.G. 奎肯施泰特（1876 - 1918）首次描述了一项旨在通过测量截瘫患者腰椎脑脊液（CSF）压力来检测脊髓CSF间隙梗阻的试验。在该试验中，腰椎穿刺时施加双侧颈静脉压迫，然后观察腰椎CSF压力的连续变化。结果分为正常、不完全脊髓阻滞或完全脊髓阻滞。这项被称为奎肯施泰特试验的检测方法在该领域得到广泛应用并进一步发展。
本系统文献综述概述了使用奎肯施泰特试验的研究中的里程碑事件。
涉及奎肯施泰特试验的临床研究在全球广泛传播。1922年，詹姆斯·B. 艾耶（1882 - 1963）通过同时测量枕大池和腰椎CSF压力，为奎肯施泰特试验提供了概念验证。他发现，在脊髓阻滞的病例中，枕大池（与腰椎相比）压力仍有反应。该试验不断完善，直到20世纪60年代，一直被视为检测椎管梗阻的常规诊断程序。非侵入性脊柱计算机断层扫描和磁共振成像的发展导致对奎肯施泰特试验的兴趣大幅下降，该试验最终从教科书和临床常规中消失。然而，在21世纪初，人们重新产生兴趣，希望通过先进的记录和计算技术揭示CSF的生物力学特性，以补充脊柱成像。
脊柱和脊髓科医生应熟悉奎肯施泰特试验，该试验不仅是脊柱诊断的一个里程碑，还为理解脊髓压迫提供了一个至今仍然有效的生理框架。
