CERVICAL-SPINE NERVE ROOT COMPRESSION - AN ANALYSIS OF NEUROFORAMINALPRESSURES WITH VARYING HEAD AND ARM POSITIONS

Study Design. Pressure measurements were taken in the neural foramina of C5, C6, and C7 nerve roots at various positions of the head and ips ilateral arm in eight fresh cadavers. Objectives. The purpose of the s tudy was to correlate clinical signs and symptoms with pressures gener ated in the neural foramen of patients with cervical radiculopathy. Su mmary of Background Data. The reliability of the clinical signs used t o diagnose cervical disc herniations has remained controversial. Previ ous studies have shown the active relationship of the cord and nerve r oots to the various movements of the spine. Methods. A standard anteri or approach was made to the cervical spine and the C5-C7 roots identif ied. A balloon catheter, attached to a pressure transducer and monitor , was inserted in the neural foramen. The head was then taken through varying degrees of flexion and extension in combination with the arm n eutral or abducted. Results. Increasing neck extension led to signific ant pressure changes at each root tested. With the movement of the arm from the neutral to abducted position, the pressure was significantly relieved. The results with neck flexion were variable. Conclusions. T he significance of this study is that it offers an explanation for the clinical observation of increasing radicular symptoms with neck exten sion and relief of these symptoms with the shoulder abduction relief m aneuver in the setting of a cervical radiculopathy.