Coin Test: A Complementary Examination for Assessing Upper Extremity Function in Cervical Myelopathy

Abstract

Study Design A prospective observational study. Objectives To explore the potential utility of the Coin Test as a valuable tool for assessing and diagnosing cervical spondylotic myelopathy (CSM). Methods In the first cohort, 36 patients with balance issues were assessed for CSM using the new Coin Test. In the second cohort, the Coin Test and mJOA scores were compared in 36 CSM patients before and 6 weeks after surgery. Results Among the 36 patients with balance problems who failed tandem gait test, 15 out of 16 (94%) CSM patients failed the Coin Test. The other 20 patients (56%) without CSM completed the Coin Test successfully but failed the tandem gait test for various reasons. The Coin Test demonstrated high specificity (100%) and sensitivity (94%) for diagnosing CSM in patients who failed tandem gait test. In the second cohort, the mJOA score improved significantly from 12 to 15 6 weeks postoperatively, and the Coin Test completion time decreased from 29.5 seconds to 16.4 seconds postoperatively ( P < 0.0001). Higher mJOA scores correlate with better performance (shorter time) on the Coin Test, both at baseline and 6 weeks post-surgery. Conclusion The Coin Test is a useful tool for evaluating hand fine motor and sensory function in CSM patients with high specificity. It also can serve as a tool for assessing surgical outcomes in patients with CSM.