Drop finger caused by 8th cervical nerve root impairment: a clinical case series

• Published in: European spine journal 2017-04, Vol.26 (4), p.1096-1100
• Main Authors: Koda, Masao, Furuya, Takeo, Rokkaku, Tomoyuki, Murakami, Masazumi, Ijima, Yasushi, Saito, Junya, Kitamura, Mitsuhiro, Ohtori, Seiji, Orita, Sumihisa, Inage, Kazuhide, Yamazaki, Masashi, Mannoji, Chikato
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Fingers - physiopathology; Fingers - surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original Article; Radiculopathy - physiopathology; Radiculopathy - surgery; Retrospective Studies; Spinal Nerve Roots - physiopathology; Spinal Nerve Roots - surgery; Surgical Orthopedics
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-016-4836-2

Purpose Recently, it has been reported that impairment by an 8th cervical nerve root lesion can cause drop finger, namely C8 drop finger. Here, we report a clinical case series of C8 drop finger to reveal the clinical outcome of surgical treatments to allow for a better choice of treatment. Methods The present study included 17 consecutive patients who were diagnosed as having C8 drop finger, in which muscle strength of the extensor digitorum communis (EDC) showed a manual muscle testing (MMT) grade of 3 or less. We retrospectively investigated the clinical characteristics of C8 drop finger and recovery of muscle power was measured by subtraction of preoperative MMT of the EDC from the final follow-up values. Results Nine cases showed recovery of muscle power of EDC, whereas the remaining eight cases did not show any recovery including two cases of deterioration. None of the conservatively treated patients showed any recovery. Surgically treated cases included two cases of deterioration. In the cases showing recovery, recovery began 9.9 months after surgery on average and recovery took 13.8 months after surgery on average. There was a significant difference in the recovery of MMT grade between the groups treated conservatively and surgically ( p  = 0.049). Preoperative MMT grade of EDC showed a moderate correlation with postoperative recovery ( r 2  = 0.45, p  = 0.003). In other words, the severity of preoperative muscular weakness correlated negatively with postoperative recovery. Conclusions C8 drop finger is better treated by surgery than conservative therapy.