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Detailed features and prognostic factors of twenty-three patients with drop finger caused by cervical radiculopathy: a retrospective multicentre study

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Data availability

All data used in the study are already provided in the tables, figures, and online supplementary materials.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Tatsuo Makino, Kei Watanabe & Hiroyuki Kawashima

  2. Spine Centre, Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan

    Tatsuo Makino, Keiichi Katsumi & Akiyoshi Yamazaki

  3. Department of Orthopaedic Surgery, Niigata Minami Hospital, Niigata City, Niigata, Japan

    Tomohiro Izumi

  4. Department of Orthopaedic Surgery, Nagaoka Chuo General Hospital, Nagaoka City, Niigata , Japan

    Yoichi Yajiri & Kazuo Takahashi

  5. Department of Orthopaedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-uonuma City, Niigata, Japan

    Toru Hirano

Authors
  1. Tatsuo Makino
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  2. Keiichi Katsumi
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  3. Akiyoshi Yamazaki
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  4. Tomohiro Izumi
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  5. Yoichi Yajiri
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  6. Kazuo Takahashi
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  7. Toru Hirano
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  8. Kei Watanabe
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  9. Hiroyuki Kawashima
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Tatsuo Makino, Keiichi Katsumi, Tomohiro Izumi and Yoichi Yajiri. The first draft of the manuscript was written by Tatsuo Makino, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tatsuo Makino.

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Ethics approval

This study was approved by the ethics committee of our hospital.

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Informed consent was obtained from all patients before enrolment.

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Informed consent was obtained from all patients before enrolment.

Conflict of interest

The authors declare no competing interests.

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Makino, T., Katsumi, K., Yamazaki, A. et al. Detailed features and prognostic factors of twenty-three patients with drop finger caused by cervical radiculopathy: a retrospective multicentre study. International Orthopaedics (SICOT) 45, 2909–2916 (2021). https://doi.org/10.1007/s00264-021-05197-w

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  • DOI: https://doi.org/10.1007/s00264-021-05197-w

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