Cervical Spine Orthopedics Practice Exam 2026 – Complete Preparation Guide

Hoffmann sign is a quick bedside indicator of upper motor neuron involvement from cervical myelopathy. It’s tested by sharply flicking the nail of the middle finger; if the response includes involuntary flexion of the thumb and index finger (and sometimes other fingers), that suggests corticospinal tract irritation from cervical cord compression. This UMN sign aligns with myelopathy, where the cervical spinal cord is affected and signals travel abnormally upward.

In contrast, Romberg assesses proprioception and dorsal column function, not necessarily the corticospinal tract; Kernig signals meningeal irritation; Phalen points to median nerve compression at the wrist. None of those directly reflect cervical UMN involvement like Hoffmann sign does.