Evaluation of hand function in patients with cervical myelopathy using positron emission tomography and kinematic analysis

2001 Fiscal Year Final Research Report Summary

• Project/Area Number: 12832018
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Institution: Fukui Medical University
• Principal Investigator: MAEZAWA Yasuhisa Fukui Medical University, Department of Orthopaedic Surgery, Assistant Professor, 医学部, 講師 (00262634)
• Co-Investigator(Kenkyū-buntansha): YONEKURA Yoshiharu Fukui Medical University, Biomedical Imaging Research Center, Professor, 医学部, 教授 (60135572) ; BABA Hisatoshi Fukui Medical University, Department of Orthopaedic Surgery, Professor, 医学部, 教授 (00165060) ; UCHIDA Kenzo Fukui Medical University, Department of Orthopaedic Surgery, Assistant, 医学部, 助手 (60273009)
• Project Period (FY): 2000 – 2001
• Keywords: Cervical myelopathy / Hand / Positron emision tomography / Kinematic analysis / 動作解析

Research Abstract

The purpose of this study is to clarify the correlation between the function of finger motion and <18>^F-2-Fluoro-Deoxy-D-Glucose Positron Emision Tomography (<18>^FDG-PET) evaluation in patients with cervical myelopathy. We conducted STEP (Simple Test for Hand Function), 10 seconds test and video-based kinematic analyzes of 18 male patients who had undergone laminoplasty and 10 age-matched male control subjects. Kinematic analysis was performed one to five years postoperatively (mean 3.3 years) using Vicon 370 system. Fourteen reflective markers of 3mm diameter were placed on the dorsal aspect of thumb, index finger and hand of the dominant upper limb. While pinching a small cube (15×15×15mm), each marker was traced by five video cameras at 60Hz. Maximum flexion angles and arcs of finger joint motion were compared between control and myelopathy hands. Average metabolic rate of glucoseof cervical cord was calculated by Kamoto's method. Total maximum angles of flexion of the index finger and thumb of myelopathy hands were significantly smaller than normal hands (p<0.01). Similarly, arcs of the motion of the DIP joint of the index finger (p<0.03), and IP joint (p<0.001) and MP joint (p<0.01) of the thumb were significantly reduced. The average metabolic rate of glucoseof cervical cord correlated STEP (r=0.503, p<0.05) and 10 seconds test (r=0.502, p<0.05). Our results demonstrate that kinematic analysis is clinically useful for the functional assessment of myelopathy bands. The reduced arc of thumb motion is possibly the most characteristic feature of pinching the cube in myelopathy hands. 18^FDG-PET imaging is potentially useful for the assessment of upper extremity in the patients with cervical myelopathy.