Comparison of Symptoms From C6 and C7 Radiculopathy
Comparison of Symptoms From C6 and C7 Radiculopathy
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DOI：
10.1097/brs.0000000000002353
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发表时间：
2017-10-15
期刊：
影响因子：
3
通讯作者：
Carkner, Eric
中科院分区：
文献类型：
--
作者：
Rainville, James;Joyce, Andrew A.;Carkner, Eric
研究设计. Case series.本研究比较了经MRI证实的C6和C7神经根受压的颈神经根病患者手臂疼痛、感觉症状和手臂无力的主观主诉的位置。颈神经根病是指由颈神经根刺激引起的手臂疼痛、感觉和运动症状。C6和C7神经根是最常见的，并且与每个神经根相关的鉴别症状已被证明是困难的。颈椎MRI可以准确识别神经根压迫，因此可以探索可能区分C6和C7神经根病的症状模式。共招募了122名症状提示颈椎神经根病的患者。其中MRI证实C6神经根受压30例，C7神经根受压39例。通过完成研究问卷，患者报告了特定的手臂无力，并在手臂的图形表示上标记了手臂疼痛和刺痛/麻木的位置。通过叠加将手臂分为54个不同区域的网格来解释标记区域。将C6和C7报告症状的频率相加，然后与似然比进行比较。功效分析计算出每组需要27例患者，基于特定症状频率的30个百分点的差异将在临床上用于区分C6和C7神经根病的假设。手臂疼痛和感觉症状是弥漫性的，C6或C7神经根病没有明显差异。41%的患者报告了一些无力，无力的具体描述对区分神经根病的价值有限。与症状性C6和C7神经根压迫相关的疼痛和感觉症状以及特异性无力主诉的位置重叠，以至于在根据症状预测神经根受累时应谨慎。
Study Design. Case series.Objective. This study compared the locations of arm pain, sensory symptoms, and subjective complaints of arm weakness in patients with cervical radiculopathy from MRI confirmed C6 and C7 nerve root compression.Summary of Background Data. Cervical radiculopathy is defined as arm pain, sensory and motor symptoms caused by irritation of a cervical nerve root. The C6 and C7 roots are most commonly involved, and differentiating symptoms associated with each root has proven difficult. Cervical MRI allows accurate identification of nerve root compression and therefore makes it possible to explore symptom patterns that may differentiate C6 from C7 radiculopathy.Methods. A total of 122 patients with symptoms suggestive of cervical radiculopathy were recruited. Of these, 30 patients had MRI confirmed C6 and 39 patients C7 nerve root compression. By completing a study questionnaire, patients reported specific arm weakness, and marked the location of arm pain and tingling/numbness on graphic representations of the arm. Marked areas were interpreted by superimposing a grid that divided the arm into 54 distinct areas. The frequencies of reported symptoms with C6 and C7 were totaled and then compared with likelihood rations. Power analysis calculated that 27 patients would be needed in each group based on the assumption that a 30 percentage point difference in frequency of specific symptom would be clinically useful for differentiating C6 from C7 radiculopathy.Results. Arm pain and sensory symptoms were diffuse, and were not distinctly different for C6 or C7 radiculopathy. Some weakness was reported by 41 percent of patients, with specific descriptions of weakness having limited value for differentiating between radiculopathies.Conclusion. The location of pain and sensory symptoms, and specific weakness complaints associated with symptomatic C6 and C7 nerve root compression overlap to the extent that caution should be exercised when predicting root involvement based on symptoms.