Detailed features and prognostic factors of twenty-three patients with drop finger caused by cervical radiculopathy: a retrospective multicentre study.
Cervical disc hernia
Cervical spondylotic radiculopathy
Drop finger
Extensor digitorum communis
Surgery
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
27
04
2021
accepted:
16
08
2021
pubmed:
29
8
2021
medline:
12
11
2021
entrez:
28
8
2021
Statut:
ppublish
Résumé
It has been reported that C7 and C8 nerve root impairment can cause drop finger; however, the clinical characteristics of each injured nerve root and post-operative outcomes remain unclear. This study aimed to investigate the detailed features and surgery-related prognostic factors of drop finger caused by cervical radiculopathy. We retrospectively investigated the clinical characteristics, paralysis patterns and surgery-related prognostic factors of 23 patients with drop finger caused by cervical radiculopathy who underwent posterior cervical foraminotomy. We classified paralysis into three patterns based on the fingers predominantly exhibiting extensor digitorum communis (EDC) muscle weakness: index finger side-dominant, middle and ring fingers-dominant and little finger side-dominant. The aetiologies were cervical disc hernia (CDH) in ten patients, cervical spondylotic radiculopathy (CSR) in eight and both CDH and CSR in five. The levels of the decompressed root were C7 in one patient, C8 in 11 and both C7 and C8 in 11. Scapular pain was frequently observed as the initial symptom (78%), especially in patients with only C8 nerve root disorder (91%). Drop finger recovered to a score of ≥ 3 on manual muscle testing in 17 patients; patients with the little finger side-dominant pattern tended to have poor recoveries. Patients with CDH improved significantly than those with CSR or both CDH and CSR (p < 0.05). Good surgical recovery of drop finger can be expected in patients with CDH and in those with index fingers-dominant and middle and ring fingers-dominant patterns.
Identifiants
pubmed: 34453192
doi: 10.1007/s00264-021-05197-w
pii: 10.1007/s00264-021-05197-w
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2909-2916Informations de copyright
© 2021. SICOT aisbl.
Références
Tanaka Y (2006) Drop fingers caused by cervical radiculopathies; its features in symptomatologies. Orthop Surg Traumatol 49:1261–1267 (in Japanese)
Cravens G, Kline DG (1990) Posterior interosseous nerve palsies. Neurosurgery 27:397–402. https://doi.org/10.1097/00006123-199009000-00009
doi: 10.1097/00006123-199009000-00009
pubmed: 2172858
Suematsu N, Hirayama T (1998) Posterior interosseous nerve palsy. J Hand Surg Br 23:104–106. https://doi.org/10.1016/s0266-7681(98)80234-9
doi: 10.1016/s0266-7681(98)80234-9
pubmed: 9571496
Koda M, Rokkaku T, Murakami M, Yamazaki M (2013) Drop finger caused by 8th cervical nerve root impairment: a report of six cases. Acta Neurochir 155:941–942. https://doi.org/10.1007/s00701-013-1684-2
doi: 10.1007/s00701-013-1684-2
pubmed: 23525686
Ono K, Ota H, Tada K, Yamamoto T (1977) Cervical myelopathy secondary to multiple spondylotic protrusions: a clinicopathologic study. Spine 2:109–125. https://doi.org/10.1097/00007632-197706000-00004
doi: 10.1097/00007632-197706000-00004
Jiang SD, Jiang LS, Dai LY (2011) Cervical spondylotic amyotrophy. Eur Spine J 20:351–357. https://doi.org/10.1007/s00586-010-1544-1
doi: 10.1007/s00586-010-1544-1
pubmed: 20694735
Furukawa M, Kamata M, Kuramoto T, Takeuchi Y, Kawabata S (2020) Surgical results of microscopic cervical foraminotomy for cervical radiculopathy presenting drop finger and proposal of classification based on drop finger patterns. Spine Surg Relat Res 4:23–30. https://doi.org/10.22603/ssrr.2019-0040
doi: 10.22603/ssrr.2019-0040
pubmed: 32039293
Kaneko K, Taguchi T, Toyoda K, Kato Y, Matsunaga T, Li Z, Kawai S (2003) Unilateral drop finger due to cervical spondylosis at the C6/7 intervertebral level. J Orthop Sci 8:616–620. https://doi.org/10.1007/s00776-003-0672-4
doi: 10.1007/s00776-003-0672-4
pubmed: 12898322
Wallace D (1982) Disc compression of the eighth cervical nerve: pseudo ulnar palsy. Surg Neurol 18:295–299. https://doi.org/10.1016/0090-3019(82)90351-2
doi: 10.1016/0090-3019(82)90351-2
pubmed: 7179091
Campbell WW, Buschbacher R, Pridgeon RM, Freeman A (1995) Selective finger drop in cervical radiculopathy: the pseudopseudoulnar claw hand. Muscle Nerve 18:108–110. https://doi.org/10.1002/mus.880180115
doi: 10.1002/mus.880180115
pubmed: 7799982
Hoppenfeld S (1977) Orthopaedic neurology. J. B. Lippincott-Company, United States of America
Kojima T, Kaneko K, Kato K et al (2006) Unilateral drop finger due to cervical spondylosis. J Jpn Spine Res Soc 17:249. (in Japanese)
Kuroda T, Abe E, Murai H et al (2007) Cervical radiculopathy associated with drop finger. Surg Tech Spine Spinal Nerves 9:185–188 (in Japanese)
Kawada T, Tani S, Taniguchi S et al (2008) Clinical features in patients with C8 radiculopathy. Cent Jpn J Orthop Surg Traumatol 51:521–522 (in Japanese)
Woods BI, Hilibrand AS (2015) Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech 28:E251–E259. https://doi.org/10.1097/BSD.0000000000000284
doi: 10.1097/BSD.0000000000000284
pubmed: 25985461
Koda M, Furuya T, Rokkaku T et al (2017) Drop finger caused by 8th cervical nerve root impairment: a clinical case series. Euro Spine J 26:1096–1100. https://doi.org/10.1007/s00586-016-4836-2
doi: 10.1007/s00586-016-4836-2
Siller S, Kasem R, Witt TN, Tonn JC, Zausinger S (2018) Painless motor radiculopathy of the cervical spine: clinical and radiological characteristics and long-term outcomes after operative decompression. J Neurosurg Spine 28:621–629. https://doi.org/10.3171/2017.10.SPINE17821
doi: 10.3171/2017.10.SPINE17821
pubmed: 29570047
Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T (2012) Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects. Eur Spine J 21:1492–1498. https://doi.org/10.1007/s00586-012-2167-5
doi: 10.1007/s00586-012-2167-5
pubmed: 22310883
pmcid: 3535253
Mizutamari M, Sei A, Tokiyoshi A, Fujimoto T, Taniwaki T, Togami W, Mizuta H (2010) Corresponding scapular pain with the nerve root involved in cervical radiculopathy. J Orthop Surg 18:356–360. https://doi.org/10.1177/230949901001800320
doi: 10.1177/230949901001800320
Bates B (1991) A guide to physical examination and history taking, 5th ed. J B Lippincott, Philadelphia
Yilmaz H, Ertürk AR, Karataş A, Atci İB, Yurt A (2016) Posterior laminoforaminotomy in the treatment of lateral cervical herniated disc and foraminal stenosis. Turk J Med Sci 46:424–429. https://doi.org/10.3906/sag-1412-61
doi: 10.3906/sag-1412-61
pubmed: 27511506
Henderson CM, Hennessy RG, Shuey HM, Shackelford EG (1983) Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery 13:504–512. https://doi.org/10.1227/00006123-198311000-00004
doi: 10.1227/00006123-198311000-00004
pubmed: 6316196
Yoo HJ, Park JH, Seong HY, Roh SW (2017) Comparison of surgical results between soft ruptured disc and foraminal stenosis patients in posterior cervical laminoforaminotomy. Korean J Neurotrauma 13:124–129. https://doi.org/10.13004/kjnt.2017.13.2.124