动态霍夫曼征与颈椎病早期诊断

Dynamic Hoffmann's sign and early diagnosis of cervical spondylotic myelopathy

目的 :研究动态霍夫曼征 (DHS)与颈椎病早期诊断的关系。 方法 :对 96例具有动态霍夫曼征阳性的颈肩痛患者进行 3～ 7年的定期随访 ,同期对 12 2例无 DHS的颈肩痛患者作为对照组进行随访。临床资料包括临床症状和体征、颈椎角位移及水平位移、椎管矢状径、Pavlov率等。 结果 :DHS组 72例发展成颈椎病并需行手术处理 ,对照组 11例症状进展 ,接受了手术治疗。 DHS组颈椎管狭窄、颈椎间盘突出以及颈椎不稳等三个方面的发生率与对照组有显著差异。结论 :DHS与颈椎病发病密切相关。一旦发现阳性 DHS,应密切观察和预防 ,症状加重者宜早期手术。

Objective:To study the relationship between dynamic Hoffmann's sign(DHS) and the early diagnosis of cervical spondylotic myelopathy. Methods:Patients with neck, shoulder and back pain (218 cases) were employed in this investigation. Among them, 96 cases had positive reaction to DHS test and they received 3 7 years follow up as study group. The other 122 cases negative to DHS test were taken as control group. The clinical data included the patient's symptoms and signs, sagittal diameter of cervical spinal canal, Pavlov rate, angular displacement and horizontal displacement between cervical vertebral, etc . Results:There were 72 cases in study group developed cervical spondylotic myelopathy and needed operation during follow up. Meanwhile, 11 cases in control group received surgical treatment. The incidence of stenosis of cervical spinal canal, herniation of cervical intervertebral disc and instability of cervical spine in DHS group were significantly higher than that of the control group. Conclusion:DHS is closely related to the onset of cervical spondylotic myelopathy. The patients should be followed up closely if they present positive reaction to DHS, and should be operated on early when their neurological symptom is progressing.