TY - JOUR
T1 - Surgical results of microscopic cervical foraminotomy for cervical radiculopathy presenting drop finger and proposal of classification based on drop finger patterns
AU - Furukawa, Mitsuru
AU - Kamata, Michihiro
AU - Kuramoto, Tetsuya
AU - Takeuchi, Yoshinori
AU - Kawabata, Soya
N1 - Publisher Copyright:
Copyright © 2020 The Japanese Society for Spine Surgery and Related Research
PY - 2020
Y1 - 2020
N2 - Introduction: In drop finger, the extension of the finger is limited, although the wrist can be flexed dorsally. There have been no well-organized reports on drop finger pattern caused by cervical nerve root disorder. Moreover, diagnosis and treatment are delayed because of the inability to distinguish cervical radiculopathy from peripheral nerve disease. This study aimed to clarify the operative outcome of microscopic cervical foraminotomy (MCF) for cervical radiculopathy presenting drop finger and to investigate whether our classification based on drop finger patterns is useful retrospectively. Methods: Overall, 22 patients with drop finger who underwent MCF were included. Grip power (GP) and longitudinal manual muscle test (MMT) score of each finger were examined. Drop finger patterns were classified as types I, II, and III. In type I, the extension disorders of the middle and ring fingers are severe and those of index and little fingers are mild. In type II, the extension disorders are severe from the little finger and slightly to index finger. In type III, the extension disorder is consistently severe in all fingers. Perioperative nerve root disorder and paralysis degree were investigated for all types. Results: The mean GP was significantly postoperatively improved in all 22 patients. The mean MMT score would benefit from exact data for almost all muscles, except the abductor pollicis brevis at the last follow-up. However, pre- and postoperative paralyses were severe in type III patients. C7 nerve root disorder was confirmed in 5/6 type I patients and C8 nerve root disorder in 12/13 type II and 3/3 type III patients. Conclusions: The operative results of MCF were relatively good, except in type III patients. As a certain tendency was confirmed between the drop finger types and injured nerve roots, our classification may be useful in reducing misdiagnosis and improving the operative results to some extent.
AB - Introduction: In drop finger, the extension of the finger is limited, although the wrist can be flexed dorsally. There have been no well-organized reports on drop finger pattern caused by cervical nerve root disorder. Moreover, diagnosis and treatment are delayed because of the inability to distinguish cervical radiculopathy from peripheral nerve disease. This study aimed to clarify the operative outcome of microscopic cervical foraminotomy (MCF) for cervical radiculopathy presenting drop finger and to investigate whether our classification based on drop finger patterns is useful retrospectively. Methods: Overall, 22 patients with drop finger who underwent MCF were included. Grip power (GP) and longitudinal manual muscle test (MMT) score of each finger were examined. Drop finger patterns were classified as types I, II, and III. In type I, the extension disorders of the middle and ring fingers are severe and those of index and little fingers are mild. In type II, the extension disorders are severe from the little finger and slightly to index finger. In type III, the extension disorder is consistently severe in all fingers. Perioperative nerve root disorder and paralysis degree were investigated for all types. Results: The mean GP was significantly postoperatively improved in all 22 patients. The mean MMT score would benefit from exact data for almost all muscles, except the abductor pollicis brevis at the last follow-up. However, pre- and postoperative paralyses were severe in type III patients. C7 nerve root disorder was confirmed in 5/6 type I patients and C8 nerve root disorder in 12/13 type II and 3/3 type III patients. Conclusions: The operative results of MCF were relatively good, except in type III patients. As a certain tendency was confirmed between the drop finger types and injured nerve roots, our classification may be useful in reducing misdiagnosis and improving the operative results to some extent.
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U2 - 10.22603/ssrr.2019-0040
DO - 10.22603/ssrr.2019-0040
M3 - Article
AN - SCOPUS:85085108834
SN - 2432-261X
VL - 4
SP - 23
EP - 30
JO - Spine Surgery and Related Research
JF - Spine Surgery and Related Research
IS - 1
ER -