ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2010
Correlation between pyramidal signs and the severity of cervical myelopathy.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 36 citations in OpenAlex.
- Prevalence of Anxiety and Depressive Symptoms in Patients With a Positive Hoffmann Sign and No Cervical Cord Compression on MRI: A Cross-Sectional Study.Health science reports · 2026Article
- Diagnostic and Surgical Decision-Making for Degenerative Cervical Myelopathy: A Survey With Post-Stratification Analysis.Global spine journal · 2026Article
- Review
- Accuracy and Reliability of Physical Signs as a Diagnostic Tool for Cervical Cord Compression: A Cross-Sectional Study.Spine surgery and related research · 2025Article
- Application of Acupuncture in Cervical Spondylotic Radiculopathy: An In-Depth Analysis and Outlook on Pathophysiological Basis and Therapeutic Mechanisms.International journal of general medicine · 2025Review
- The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy - A Systematic review and Meta-analysis.Global spine journal · 2024Review
- The Essence of Clinical Practice Guidelines for Cervical Spondylotic Myelopathy, 2020.Spine surgery and related research · 2024Article
- Physical Performance Tests in Adult Neck Pain Patients with and without Clinical Myelopathic Signs: A Matched Case-Control Study.International journal of environmental research and public health · 2022Article
- Prevalence and Associated Factors of Clinical Myelopathy Signs in Smartphone-Using University Students with Neck Pain.International journal of environmental research and public health · 2022Article
- Assessment of degenerative cervical myelopathy differs between specialists and may influence time to diagnosis and clinical outcomes.PloS one · 2018Article
- Multilevel critical stenosis with minimal functional deficits: a case of cervical spondylotic myelopathy.Spinal cord series and cases · 2018Article
- Characteristics of C6-7 myelopathy: assessment of clinical symptoms and electrophysiological findings.Spinal cord · 2016Article
- Retraction: Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy.Asian spine journal · 2016Article
- Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI.European radiology · 2016Article
- Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy.Asian spine journal · 2016Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A retrospective study was performed to determine the sensitivities of the pyramidal signs in patients with cervical myelopathy, focusing on those with increased signal intensity (ISI) in T2-weighted magnetic resonance imaging (MRI). The relationship between prevalence of the pyramidal signs and the severity of myelopathy was investigated. We reviewed the records of 275 patients with cervical myelopathy who underwent surgery. Of these, 143 patients were excluded from this study due to comorbidities that might complicate neurological findings. The MR images of the remaining 132 patients were evaluated in a blinded fashion. The neurological findings of 120 patients with ISI (90 men and 30 women; mean age 61 years) were reviewed for hyperreflexia (patellar tendon reflex), ankle clonus, Hoffmann reflex, and Babinski sign. To assess the severity of myelopathy, the motor function scores of the upper and lower extremities for cervical myelopathy set by the Japanese Orthopaedic Association (m-JOA score) were used. The most prevalent signs were hyperreflexia (94%), Hoffmann reflex (81%), Babinski sign (53%), and ankle clonus (35%). Babinski sign (P < 0.001), ankle clonus, and Hoffmann reflex showed significant association with the lower m-JOA score. Conversely, no association was found with the upper m-JOA score. In patients with cervical myelopathy, hyperreflexia showed the highest sensitivity followed by Hoffmann reflex, Babinski sign, and ankle clonus. The prevalence of the pyramidal signs correlated with increasing severity of myelopathy. Considering their low sensitivity in patients with mild disability, the pyramidal signs may have limited utility in early diagnosis of cervical myelopathy.
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