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Clinical signs in patients with brachialgia and sciatica: a comparative study
C Woertgen1, M Holzschuh, R D Rothoerl
1Neurosurgical Clinic, University of Regensburg, Germany.
Surgical Neurology
|February 11, 1998
Summary
Clinical signs of cervical root compression differ from lumbar root compression. Cervical root affection patients show less radicular pain radiation than expected, challenging traditional concepts.
Area of Science:
- Neurology
- Orthopedic Surgery
Background:
- Comparing clinical presentations of cervical and lumbar root affections.
- Investigating differences in pain radiation and neurological deficits.
Purpose of the Study:
- To compare clinical signs in patients with cervical versus lumbar root affections.
- To evaluate the diagnostic value of pain radiation patterns.
Main Methods:
- Prospective study of 395 patients (93 cervical, 302 lumbar root affection).
- Analysis of general data, medical history, and neurological findings.
- 338 patients underwent surgical intervention.
Main Results:
- Cervical root affection patients (brachialgia) had nonradicular pain radiation in 67%, versus 35% in lumbar root affection patients (sciatica).
- Radicular pain radiation strongly correlated with unequivocal radicular deficit.
- Cervical radicular pain radiation showed a highly significant incidence of neurological deficit.
Conclusions:
- Only one-third of cervical root affection patients exhibited unequivocal radicular pain radiation, contradicting textbook concepts.
- Anatomical variations in cervical root anastomoses may explain clinical sign differences.
- Further myotome investigation is recommended for precise cervical root level determination.