Relationship between toe standing test and cervical spondylotic myelopathy: a new clinical sign

Abstract

Abstract Background We have discovered a new phenomenon in clinical practice called the toe standing test (TST), which has never been described and reported before. Based on the correlation of the toe TST with the relevant clinical data of patients with cervical spondylotic myelopathy (CSM) to determine whether it can be used as a new sign for the CSM. Methods The clinical data related to patients who visited our hospital for spinal cervical spondylosis were retrospectively collected. The general data and demographic characteristics of the patients were counted. The location of compression, compression segment, cause of compression, continuity of cerebrospinal fluid signal, alteration of spinal cord signal, muscle strength of lower limbs, grip strength of both hands, muscle tone of both lower limbs, Hoffmann's sign, and cervical JOA score were counted. The results of TST in CSM patients were recorded. Patients were grouped according to whether their TST results were positive or not, and the general information and clinical data of the two groups were compared statistically. Results A total of 171 patients with CSM were included, with a mean age of 61.1053 ± 12.7395 years and a positive toe standing test rate of 45.029% (77/171). The CSM patients were divided into positive (n = 77) and negative groups (n = 94). The differences in cerebrospinal fluid signal continuity and cervical JOA scores between patients in different groups were statistically significant (P < 0.05). The differences in the results of the remaining observations were not statistically significant. The results of univariate regression analysis did not see the above-mentioned observables as risk factors. Conclusion TST is closely related to CSM, and patients with positive TST may have long-term compression of the cervical spinal cord. TST may be a new clinical sign of CSM, and combined with the cervical JOA score, this test can assess the severity of spinal cervical spondylosis.