Investigation of the effect of cervical radiculopathy on peripheral nerves of the upper extremity with high-resolution ultrasonography

Abstract

Study Design. Prospective, cross-sectional observational study. Objective. 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. Summary of Background Data. 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. Methods. 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. Results. 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. Conclusion. 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.