Farmer J C, Wisneski R J
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia.
Spine (Phila Pa 1976). 1994 Aug 15;19(16):1850-5. doi: 10.1097/00007632-199408150-00010.
Pressure measurements were taken in the neural foramina of C5, C6, and C7 nerve roots at various positions of the head and ipsilateral arm in eight fresh cadavers.
The purpose of the study was to correlate clinical signs and symptoms with pressures generated in the neural foramen of patients with cervical radiculopathy.
The reliability of the clinical signs used to diagnose cervical disc herniations has remained controversial. Previous studies have shown the active relationship of the cord and nerve roots to the various movements of the spine.
A standard anterior approach was made to the cervical spine and the C5-C7 roots identified. 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 neutral or abducted.
Increasing neck extension led to significant 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.
The significance of this study is that it offers an explanation for the clinical observation of increasing radicular symptoms with neck extension and relief of these symptoms with the shoulder abduction relief maneuver in the setting of a cervical radiculopathy.
在八具新鲜尸体上，于头部和同侧手臂的不同位置测量C5、C6和C7神经根神经孔处的压力。
本研究的目的是将临床体征和症状与神经根型颈椎病患者神经孔内产生的压力相关联。
用于诊断颈椎间盘突出症的临床体征的可靠性一直存在争议。先前的研究表明脊髓和神经根与脊柱的各种运动之间存在动态关系。
采用标准的前路入路至颈椎并识别C5 - C7神经根。将连接压力传感器和监测器的球囊导管插入神经孔。然后使头部进行不同程度的屈伸，同时手臂处于中立位或外展位。
颈部伸展增加导致每个测试神经根处出现显著的压力变化。随着手臂从中立位移动到外展位，压力明显减轻。颈部屈曲的结果则各不相同。
本研究的意义在于，它为神经根型颈椎病患者中随着颈部伸展神经根症状加重以及通过肩部外展缓解动作缓解这些症状的临床观察提供了解释。
