THE PATHOMECHANICS OF CHRONIC, RECURRENT CERVICAL NERVE ROOT NEURAPRAXIA - THE CHRONIC BURNER SYNDROME

This study defined chronic recurrent cervical nerve root neurapraxia, the chronic burner syndrome, characterized the clinical findings, and described the responsible pathomechanics. We studied a subset of 55 at hletes (mean age, 22 years) for evaluation of recurrent burners. Eleve n subjects were professional athletes. The mechanism of injury was ext ension combined with ipsilateral-lateral deviation in 46 patients (83% ). Spurling's sign was positive in 39 patients (70%). Twenty-nine pati ents (53%) had developmentally narrowed cervical canals, and 48 patien ts (87%) had evidence of disk disease by magnetic resonance imaging. T he disk disease was in the form of a disk bulge, disk protrusion, or a frank disk herniation deforming the cord. Fifty-one patients (93%) ha d disk disease or narrowing of the intervertebral foramina secondary t o degenerative disk disease. Although burners may be the result of a b rachial plexus stretch injury in high school and collegiate football p layers seen with acute symptoms, nerve root compression in the interve rtebral foramina secondary to disk disease is a more common cause in c ollegiate and professional players who have recurrent or chronic burne r syndromes. There is a high incidence of cervical canal stenosis in f ootball players with recurrent burner syndrome. The combination of dis k disease and cervical spinal canal stenosis may lead to an alteration in normal cervical spine mechanics that may make these athletes more prone to chronic burner syndromes.