A Clinical Correlation Research of the Hoffmann Sign and Neurological Imaging Findings in Cervical Spinal Cord Compression

World Neurosurg. 2019 Aug:128:e782-e786. doi: 10.1016/j.wneu.2019.04.254. Epub 2019 May 9.

Abstract

Background: The Hoffmann sign is usually used as an indicator of upper motor neuron lesion, but its clinical effect remains controversial in previous reports.

Methods: A retrospective case control study including 107 patients with cervical complaints was carried out. According to the presence of Hoffmann sign, patients were divided into 2 groups. The radiographic results were assessed and the sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology, segment, cervical spine canal ratio, and S-index were calculated.

Results: There were 56 patients in the positive Hoffmann group and 51 patients in negative group. The sensitivity, specificity, positive and negative predictive values, and false positive and false negative values of Hoffmann sign for cervical pathology were found to be 61.6%, 85.7%, 94.6%, 35.3%, 14.3%, 38.4% and 60.5%, 81.0%, 92.9%, 33.3%, 19.0%, 39.5%, respectively. The ratio of cervical spine canal was lower in the positive Hoffmann group than in control group.

Conclusions: Although the Hoffmann sign is not foolproof in the diagnosis of cervical spinal cord compression, it can be used to assess symptomatic patients. The narrower the cervical spine canal or the higher the cervical segment compression, the higher of the incidence of positive Hoffmann sign.

Keywords: Cervical; Clinical correlation; Hoffmann sign; Magnetic resonance imaging.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cervical Vertebrae / diagnostic imaging*
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroimaging / methods
  • Neurologic Examination / methods*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spinal Cord Compression / diagnosis*
  • Spinal Cord Compression / diagnostic imaging*