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Quantitative assessment of hand disability by the Nine-Hole-Peg test (9-HPT) in cervical spondylotic myelopathy

Gait disturbances and sensory deficit in the hands are the most common clinical features in cervical spondylotic myelopathy (CSM). The disease course is often insidious and slow. The treatment for the underlying cervical-canal stenosis is surgical decompression or stabilisation. Functional scales have been used in CSM to assess neurological impairment, including the Nurick scale1 and the modified Japanese Orthopedic Association (mJOA) scale.2 Whereas functional scales are helpful in quantifying patient disability, they lack the objectivity of a neurological examination. A timed walking test as a quantitative functional test focusing on gait impairment has recently been developed.3 The present study has assessed hand disability in CSM patients with the quantitative Nine-Hole-Peg Test (9-HPT). This easy-to-use test was developed in 1985,4 and is now extensively applied to measure hand dexterity in multiple sclerosis (MS).5 Nine-HPT could constitute a quantifying complementary test to the Walking Time test in CSM to explore the two main symptoms—gait and hand disability.

Forty patients with CSM, corroborated by MRI, were recruited between January 2003 and March 2006. Patients with other known neurological disease were excluded from this study. A posterior decompressive procedure was undergone in all patients.

Twenty healthy subjects were assessed with the 9-HPT to give the normal range values in our …