USEFULNESS AND RELIABILITY OF NEUROLOGICAL SIGNS FOR LEVEL DIAGNOSIS IN CERVICAL MYELOPATHY CAUSED BY SOFT DISC HERNIATION

We retrospectively analyzed neurological signs of 106 patients with ce rvical myelopathy caused by single-level soft disc herniation. Neurolo gical signs that were intensively analyzed were deep tendon reflexes, the uppermost level of impaired pin-prick sensation, the uppermost wea k muscle, and region of numbness in the hands. Characteristic signs fo r each intervertebral level were deduced, and sensitivity, specificity , and accuracy of these signs were calculated. Deep tendon reflexes we re specific signs for each intervertebral level, although not as sensi tive as the neurological signs. Muscle weakness and pinprick sensation were neither sensitive nor specific. Hand numbness was moderately sen sitive and specific. On the whole, there was no neurological sign that was both highly sensitive and specific for an intervertebral level, a nd therefore, neurological level diagnosis in cervical myelopathy shou ld be performed comprehensively according to more specific signs, i.e. , deep tendon reflexes and hand numbness.