Purpose: To identify patients presenting with neck pain with cervical myelopathy based on specific patient characteristics.
Stage of CPR Development: Derivation.
Rule:
1. Gait deviation
2. Positive Hoffmann’s test
3. Positive inverted supinator sign
4. Positive Babinski test
5. Age > 45 years
Interpretation:
| Variables | Sensitivity | Specificity | +LR | Post-Test Prob |
| 1 | 0.94 | 0.31 | 1.40 | 43% |
| 2 | 0.39 | 0.88 | 3.30 | 64% |
| 3 | 0.19 | 0.99 | 30.90 | 94% |
| 4 | 0.09 | 1.00 | ∞ | 99% |
Research:
1. Cook CE, et al. Clustered clinical findings for diagnosis of cervical spine myelopathy. J Man Manip Ther. 2010; 18(4): 175-180.
Continued Learning…
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John Snyder, DPT 
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