Department of Physical Medicine and Rehabilitation, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey.
Department of Anesthesiology and Reanimation, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey.
Spine (Phila Pa 1976). 2018 Jul 15;43(14):E798-E803. doi: 10.1097/BRS.0000000000002539.
Prospective, cross-sectional observational study.
We aimed to investigate the effects of chronic cervical radiculopathy (CR) on the cross-sectional area (CSA) values of the cervical nerve roots (CNRs), median, ulnar, and radial nerves with high-resolution ultrasonography.
Symptomatic nerve roots are wider than asymptomatic nerve roots due to the presence of edema. Peripheral nerves have also been shown to develop edema, fibrosis, and changes distal to the affected nerve as a result of mechanical compression. In addition according to "double-crush syndrome" hypothesis, the peripheral nerves are more sensitive to pressure, and a proximal nerve lesion makes the distal segment of the nerve more susceptible to anatomic deterioration by causing interruption in the axoplasmic conduction due to compression.
Forty patients with chronic CR were included to the study. Both affected CNRs and the contralateral nerve roots (control group) were evaluated with high-resolution ultrasonography. Ulnar and median nerve CSA measurements were performed at four measurement points and radial nerve measurements at a single measurement point.
CSA measurements were statistically significantly higher at the CNR of the affected side compared to the unaffected side. There was no statistically significant difference when affected and unaffected sides were compared in terms of measurements performed from median, ulnar, and radial nerves at all measurement points.
The results of the present study indicate that the changes in the CNR caused by CR do not have any effect on the peripheral nerves. We did not find any affection in peripheral nerve CSA that might have been suggestive of double-crush syndrome in CR.
前瞻性、横断面观察性研究。
我们旨在通过高分辨率超声检查研究慢性颈神经根病（CR）对颈椎神经根（CNR）、正中神经、尺神经和桡神经的横截面积（CSA）值的影响。
由于存在水肿，症状性神经根比无症状神经根更宽。由于机械压迫，外周神经也被证明会在受影响的神经远端发生水肿、纤维化和变化。此外，根据“双重挤压综合征”假说，外周神经对压力更敏感，近端神经病变会因压迫导致轴浆传导中断，从而使神经远端更容易受到解剖恶化，从而使神经远端更容易受到神经病变的影响。
本研究纳入了 40 例慢性 CR 患者。使用高分辨率超声对受累 CNR 和对侧神经根（对照组）进行评估。在四个测量点测量尺神经和正中神经 CSA，在一个测量点测量桡神经 CSA。
与健侧相比，患侧 CNR 的 CSA 测量值显著更高。在所有测量点，与健侧相比，患侧和健侧的正中神经、尺神经和桡神经的测量值均无统计学差异。
本研究结果表明，CR 引起的 CNR 变化对外周神经没有任何影响。我们没有发现 CR 中可能提示双重挤压综合征的外周神经 CSA 受累。
2。
