C6 和 C7 神经根病变症状的比较。
Comparison of Symptoms From C6 and C7 Radiculopathy.
机构信息
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.
New England Baptist Hospital, Boston, MA.
出版信息
Spine (Phila Pa 1976). 2017 Oct 15;42(20):1545-1551. doi: 10.1097/BRS.0000000000002353.
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.
LEVEL OF EVIDENCE
研究设计
病例系列。
目的
本研究比较了经 MRI 证实的 C6 和 C7 神经根受压的颈椎病患者手臂疼痛、感觉症状和手臂无力的主观主诉的位置。
背景资料总结
颈椎病是指由于颈椎神经根受到刺激而引起的手臂疼痛、感觉和运动症状。C6 和 C7 神经根最常受累，区分与每个神经根相关的症状一直很困难。颈椎 MRI 可以准确识别神经根受压，因此有可能探索可能区分 C6 和 C7 神经根病的症状模式。
方法
共招募了 122 名有颈椎病症状的患者。其中，30 名患者的 MRI 证实为 C6 神经根受压，39 名患者为 C7 神经根受压。通过填写研究问卷，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。标记区域通过叠加一个将手臂分为 54 个不同区域的网格进行解释。报告的 C6 和 C7 症状的频率进行了汇总，然后与可能性比率进行了比较。根据假设，在区分 C6 和 C7 神经根病方面，特定症状频率的 30 个百分点差异将具有临床意义，对每组 27 名患者进行了功率分析。
结果
手臂疼痛和感觉症状是弥漫性的，对于 C6 或 C7 神经根病没有明显区别。41%的患者报告了一些无力，对无力的具体描述对区分神经根病的价值有限。
结论
与症状相关的 C6 和 C7 神经根受压的疼痛和感觉症状的位置以及特定的无力主诉重叠，因此基于症状预测神经根受累时应谨慎。
证据水平
3 级。
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