Rapid opening and closing of the hand as a measure of early neurologic recovery in the upper extremity after surgery for cervical spondylotic myelopathy

Prabhu K, Babu S, Samuel S, Chacko AG. Rapid opening and closing of the hand as a measure of early neurologic recovery in the upper extremity after surgery for cervical spondylotic myelopathy. To compare the results of a simple bedside test with the Jebsen-Taylor hand function test, in the assessment of early improvement of neurologic function after surgery for cervical spondylotic myelopathy (CSM). Case series comparing the bedside test with the Jebsen-Taylor test of hand function as the criterion standard in a blinded comparison. Referral center, institutional practice, hospitalized care. One hundred referent subjects and 26 consecutive patients undergoing surgery for CSM. Decompressive cervical spine surgery. Complete, rapid opening and closing of the hand was timed for 20, 40, and 60 repetitions, the Rapid Hand Flick Time (RHFT), preoperatively and in the first week postoperatively. The results of this test were correlated with the Jebsen-Taylor test. There was a 40% to 50% prolongation in the RHFT compared with age-matched referent subjects. Postoperatively, there was a 3.84-second mean improvement in the RHFT for 20 repetitions in the right hand and 2.8 seconds in the left hand. A paired-samples t test, comparing the preoperative and postoperative day 1 and day 7 timings, showed a statistically significant improvement ( P