Makin G J, Brown W F, Ebers G C
J Neurol Neurosurg Psychiatry. 1986 Jun;49(6):640-4. doi: 10.1136/jnnp.49.6.640.
Lesions of the seventh cervical (C7) root are common and cause a readily recognised neurological syndrome. Recognition of this pattern is essential in differentiating C7 root lesions from lesions of the brachial plexus or peripheral nerves. Serratus anterior weakness is not generally included in this syndrome. We report six verified cases of C7 radiculopathy in which weakness of the serratus anterior was present in addition to the usual findings. This was manifest as winging of the scapula, when pushing forward against a wall, either with the hands at shoulder level or, in some cases, only when the hands were lowered to waist level. This latter method of testing places the muscle at a mechanical disadvantage and reveals partial paralysis. Analysis of this clinical finding complements anatomical evidence suggesting that the powerful lower digitations of the muscle may be primarily supplied by the C7 root in some cases. Scapular winging, apparent either in the usual position or the modified position described here, should be recognised as consistent with a diagnosis of C7 radiculopathy. When present, this sign serves to differentiate C7 radiculopathy from lesions of the brachial plexus or radial nerve.
第七颈神经（C7）根损伤很常见，会导致一种易于识别的神经综合征。识别这种模式对于区分C7神经根损伤与臂丛神经或周围神经损伤至关重要。前锯肌无力通常不包括在该综合征中。我们报告了6例经证实的C7神经根病病例，这些病例除了有常见表现外，还存在前锯肌无力。这表现为当靠在墙上向前推时肩胛骨翼状突出，双手位于肩部水平时如此，在某些情况下，仅当双手放低至腰部水平时才会出现。后一种测试方法使肌肉处于机械劣势，揭示了部分麻痹。对这一临床发现的分析补充了解剖学证据，表明在某些情况下，该肌肉强大的下部肌齿可能主要由C7神经根支配。肩胛骨翼状突出，无论是在通常位置还是此处描述的改变位置出现，都应被视为与C7神经根病的诊断一致。当出现这种体征时，有助于将C7神经根病与臂丛神经或桡神经损伤区分开来。
