Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra

Fang Luo; Jun Chen; Shan Wu; Shan He

doi:doi:10.11648/j.ijmi.20210903.12

| Peer-Reviewed

Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra

Fang Luo, Jun Chen, Shan Wu, Shan He

Published in International Journal of Medical Imaging (Volume 9, Issue 3)

Received: 15 June 2021 Accepted: 5 July 2021 Published: 21 July 2021

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Brachial plexus injury is a complex nerve injury. This may be due to the anatomical complexity of the brachial plexus. Purpose: To obtain sonographic characteristics and oblique sagittal diameter of cervical nerve root by high frequency ultrasound, and the morphology of brachial plexus was described. Methods: Two hundred and twenty-one subjects were recruited in our ultrasonography laboratory between March and December 2016. Their ultrasonographic characteristics of bilateral brachial plexus and cervical nerve roots were obtained by ultrasound, and they were measured with high echo sites on the bone cortex of anterior or posterior tubercles as positioning points in oblique sagittal. Results: 1. Cross-sectional sonogram of brachial plexus showed round and (or) oval “uniform” hypoechoic masses in the gap between anterior scalene muscle with middle scalene muscle, which were arranged in an arc shape; uniform low echo detected in short axis section and long axis section imaging of nerve bundles, which were wrapped by slightly hyper echoic epineuria. 2. Ultrasonographic imaging demonstrated that cervical nerve roots arranged between anterior tubercle and posterior tubercle, and the displaying rate of nerve roots of C4 to C7 was 100%; the displaying rate of nerve root of C8 was 78%. 3. Normal values of the diameters of cervicalr root nerves at intervertebral foramen were: C4, 2.65±0.27 mm; C5, 3.33±0.33 mm; C6, 3.76±0.36 mm; C7, 4.84±0.30 mm; C8, 3.48±0.34 mm. Conclusion: 1. Oblique sagittal imaging, nerve root of C7 is the thickest among all nerve roots of all examinee; 2. The diameter that of cervical nerve root of C4 may be positively correlated with the height.

Published in	International Journal of Medical Imaging (Volume 9, Issue 3)
DOI	10.11648/j.ijmi.20210903.12
Page(s)	141-148
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

High Frequency Ultrasound, Cervical Spondylosis, Degeneration of Cervical Vertebra, Cervical Nerve Root, Magnetic Resonance Imaging, Intervertebral Foramen

References

[1]	Vanessa Baute, Jeffrey A Strakowski, Jon W Reynolds, et al. Neuromuscular ultrasound of the brachial plexus: A standardized approach. Muscle Nerve. 2018; 58: 618-24.
[2]	J-L Christophe, F Berthier, A Boillot, et al. Assessment of topographic brachial plexus nerves variations at the axilla using ultrasonography. Br J Anaesth. 2009; 103: 606-12.
[3]	Daniel Boczar, Antonio J Forte, Jeremie D Oliver, et al. Intraoperative evaluation of cervical nerve root avulsion using ultra-high-frequency ultrasound system. Case Reports Plast Surg Hand Surg. 2019; 6: 43–46.
[4]	O Kenechi Nwawka. Ultrasound Imaging of the Brachial Plexus and Nerves About the Neck. Ultrasound Q. 2019; 35: 110-19.
[5]	Khalid M Abbed, Jean-Valéry C E Coumans. Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation. Neurosurgery. 2007; 60: S28-34.
[6]	James F Griffith, Radhesh Krishna Lalam. Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI. Semin Musculoskelet Radiol. 2019; 23: 405-18.
[7]	Zhengyi Li, Xun Xia, Xiaoming Rong, et al. Structure of the brachial plexus root and adjacent regions displayed by ultrasound imaging. Neural Regen Res. 2012; 7: 2044-50.
[8]	Royse CE, Sha S, Soeding PF, et al. Anatomical study of the branchial plexus using surface ultrasound. Anaesth Intensive Care. 2006; 34: 203-10.
[9]	Rune Lau Jakobsen, Anders Fuglsang-Frederiksen, Michel Bach Hellfritzsch, et al. A prospective study of high resolution ultrasound in brachial plexopathies-Correlation with electrophysiological measurements. Clin Neurophysiol. 2019; 130: 1144-50.
[10]	Lapegue F, Faruch-Bilfeld M, Demondion X, et al. Ultrasonography of the brachial plexus, normal appearance and practical applications. Diagn Intervent Imaging. 2014; 95: 259-75.
[11]	Griffith JF. Ultrasound of the brachial plexus. Semin Musculoskelet Radiol. 2018; 22: 323-33.
[12]	Martinoli C, Bianchi S, Santacroce E, et al. Brachial plexus sonography: a technique for assessing the root level. AJR Am J Roentgenol. 2002; 179: 699-2.
[13]	Minjuan Zheng, Yongsheng Zhu, Xiaodong Zhou, et al. Diagnosis of closed injury and neoplasm of the brachial plexus by ultrasonography. J Clin Ultrasound. 2014; 42: 417-22.
[14]	Wenying Wang, and Qiao Wang. Sonographic measurements of normal C5-C8 nerve roots in children. Muscle Nerve. 2020; 61: 649–53.
[15]	James F Griffith. Ultrasound of the Brachial Plexus Semin. Musculoskelet Radiol. 2018; 22: 323-33.
[16]	Kubiena H, Hormann M, Michlits W, et al. Intraoperative imaging of the brachial plexus by high-resolution ultrasound. J Reconstr Microsurg. 2005; 21: 429–33.
[17]	Caldana WCI, Kodaira SK, Cavalcanti CFA, et al. Value of ultrasound in the anatomical evaluation of the brachial plexus: correlation with magnetic resonance imaging. Radiol Bras. 2018; 51: 358-65.
[18]	Gonzalez NL, Hobson-Webb LD. Neuromuscular ultrasound in clinical practice: A review. Clin Neurophysiol Pract. 2019; 4: 148-63.
[19]	Perlas A, Chan VW, Simons M. Brachial plexus examination and localization using ultrasound and electrical stimulation: a volunteer study. Anesthesiology. 2003; 99: 429-35.
[20]	Demondion X, Herbinet P, Boutry N, et al. Sonographic mapping of the normal brachial plexus. Am J Neuroradiol. 2003; 24: 1303-09.
[21]	Zaidman CM, Al-Lozi M, Pestronk A. Peripheral nerve size in normals and patients with polyneuropathy: an ultrasound study. Muscle Nerve. 2009; 40: 960-66.
[22]	Smith EC, Xixis KI, Grant GA, et al. Assessment of obstetric plexus injury with preoperative ultrasound. Muscle Nerve. 2016; 53: 946-50.
[23]	Padua L, Granata G, Sabatelli M, et al. Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol. 2014; 125: 160–65.
[24]	Mikinobu Takeuchi, Norimitsu Wakao, Atsuhiko Hirasawa, et al. Ultrasonography has a diagnostic value in the assessment of cervical radiculopathy: A prospective pilot study. Eur Radiol. 2017; 27: 3467-73.
[25]	Gore DR. Roentgengraphic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine (Phila Pa 1976). 2001; 26: 2463-66.
[26]	Burcu Metin Ökmen, Korgün Ökmen, Lale Altan. Investigation of the Effect of Cervical Radiculopathy on Peripheral Nerves of the Upper Extremity with High-Resolution Ultrasonography. Spine (Phila Pa 1976). 2018; 15; 43: E798-803.
[27]	Won SJ, Kim BJ, Park KS, et al. Measurement of cross-sectional area of cervical roots and brachial plexus trunks. Muscle Nerve. 2012; 46: 711-16.
[28]	Chen Y, Kumar N, Lim JW, et al. High-resolution sonography detects extraforaminal nerve pathology in patients initially diagnosed with cervical disc disease: a case series. J Clin Ultrasound. 2013; 41: 46-54.
[29]	Wenying Wang, Qiao Wang. Sonographic measurements of normal C5-C8 nerve roots in children. Muscle Nerve. 2020; 61: 649-53.
[30]	Franco CD, Williams JM. Ultrasound-guided interscalene block reevaluation of the “stoplight” sign and clinical implications. Reg Anesth Pain Med. 2016; 41: 452-59.
[31]	Vanderhave KL, Brighton B, Casey V, et al. Applications of musculoskeletal ultrasonography in pediatric patients. J Am Acad Orthop Surg. 2014; 22: 691-98.

Cite This Article

Plain Text BibTeX RIS

APA Style

Fang Luo, Jun Chen, Shan Wu, Shan He. (2021). Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. International Journal of Medical Imaging, 9(3), 141-148. https://doi.org/10.11648/j.ijmi.20210903.12

Copy | Download

ACS Style

Fang Luo; Jun Chen; Shan Wu; Shan He. Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. Int. J. Med. Imaging 2021, 9(3), 141-148. doi: 10.11648/j.ijmi.20210903.12

Copy | Download

AMA Style

Fang Luo, Jun Chen, Shan Wu, Shan He. Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. Int J Med Imaging. 2021;9(3):141-148. doi: 10.11648/j.ijmi.20210903.12

Copy | Download

@article{10.11648/j.ijmi.20210903.12,
  author = {Fang Luo and Jun Chen and Shan Wu and Shan He},
  title = {Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra},
  journal = {International Journal of Medical Imaging},
  volume = {9},
  number = {3},
  pages = {141-148},
  doi = {10.11648/j.ijmi.20210903.12},
  url = {https://doi.org/10.11648/j.ijmi.20210903.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20210903.12},
  abstract = {Background: Brachial plexus injury is a complex nerve injury. This may be due to the anatomical complexity of the brachial plexus. Purpose: To obtain sonographic characteristics and oblique sagittal diameter of cervical nerve root by high frequency ultrasound, and the morphology of brachial plexus was described. Methods: Two hundred and twenty-one subjects were recruited in our ultrasonography laboratory between March and December 2016. Their ultrasonographic characteristics of bilateral brachial plexus and cervical nerve roots were obtained by ultrasound, and they were measured with high echo sites on the bone cortex of anterior or posterior tubercles as positioning points in oblique sagittal. Results: 1. Cross-sectional sonogram of brachial plexus showed round and (or) oval “uniform” hypoechoic masses in the gap between anterior scalene muscle with middle scalene muscle, which were arranged in an arc shape; uniform low echo detected in short axis section and long axis section imaging of nerve bundles, which were wrapped by slightly hyper echoic epineuria. 2. Ultrasonographic imaging demonstrated that cervical nerve roots arranged between anterior tubercle and posterior tubercle, and the displaying rate of nerve roots of C4 to C7 was 100%; the displaying rate of nerve root of C8 was 78%. 3. Normal values of the diameters of cervicalr root nerves at intervertebral foramen were: C4, 2.65±0.27 mm; C5, 3.33±0.33 mm; C6, 3.76±0.36 mm; C7, 4.84±0.30 mm; C8, 3.48±0.34 mm. Conclusion: 1. Oblique sagittal imaging, nerve root of C7 is the thickest among all nerve roots of all examinee; 2. The diameter that of cervical nerve root of C4 may be positively correlated with the height.},
 year = {2021}
}

Copy | Download

TY - JOUR
T1 - Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra
AU - Fang Luo
AU - Jun Chen
AU - Shan Wu
AU - Shan He
Y1 - 2021/07/21
PY - 2021
N1 - https://doi.org/10.11648/j.ijmi.20210903.12
DO - 10.11648/j.ijmi.20210903.12
T2 - International Journal of Medical Imaging
JF - International Journal of Medical Imaging
JO - International Journal of Medical Imaging
SP - 141
EP - 148
PB - Science Publishing Group
SN - 2330-832X
UR - https://doi.org/10.11648/j.ijmi.20210903.12
AB - Background: Brachial plexus injury is a complex nerve injury. This may be due to the anatomical complexity of the brachial plexus. Purpose: To obtain sonographic characteristics and oblique sagittal diameter of cervical nerve root by high frequency ultrasound, and the morphology of brachial plexus was described. Methods: Two hundred and twenty-one subjects were recruited in our ultrasonography laboratory between March and December 2016. Their ultrasonographic characteristics of bilateral brachial plexus and cervical nerve roots were obtained by ultrasound, and they were measured with high echo sites on the bone cortex of anterior or posterior tubercles as positioning points in oblique sagittal. Results: 1. Cross-sectional sonogram of brachial plexus showed round and (or) oval “uniform” hypoechoic masses in the gap between anterior scalene muscle with middle scalene muscle, which were arranged in an arc shape; uniform low echo detected in short axis section and long axis section imaging of nerve bundles, which were wrapped by slightly hyper echoic epineuria. 2. Ultrasonographic imaging demonstrated that cervical nerve roots arranged between anterior tubercle and posterior tubercle, and the displaying rate of nerve roots of C4 to C7 was 100%; the displaying rate of nerve root of C8 was 78%. 3. Normal values of the diameters of cervicalr root nerves at intervertebral foramen were: C4, 2.65±0.27 mm; C5, 3.33±0.33 mm; C6, 3.76±0.36 mm; C7, 4.84±0.30 mm; C8, 3.48±0.34 mm. Conclusion: 1. Oblique sagittal imaging, nerve root of C7 is the thickest among all nerve roots of all examinee; 2. The diameter that of cervical nerve root of C4 may be positively correlated with the height.
VL - 9
IS - 3
ER -

Copy | Download

Author Information

Fang Luo

Department of Neurology, The Affiliated Hosptial of Guizhou Medical University, Guiyang, China
Jun Chen

Department of Neurology, The Affiliated Hosptial of Guizhou Medical University, Guiyang, China
Shan Wu

Department of Neurology, The Affiliated Hosptial of Guizhou Medical University, Guiyang, China
Shan He

Department of Neurology, The Affiliated Hosptial of Guizhou Medical University, Guiyang, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Fang Luo, Jun Chen, Shan Wu, Shan He. (2021). Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. International Journal of Medical Imaging, 9(3), 141-148. https://doi.org/10.11648/j.ijmi.20210903.12

Copy | Download

ACS Style

Fang Luo; Jun Chen; Shan Wu; Shan He. Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. Int. J. Med. Imaging 2021, 9(3), 141-148. doi: 10.11648/j.ijmi.20210903.12

Copy | Download

AMA Style

Fang Luo, Jun Chen, Shan Wu, Shan He. Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra. Int J Med Imaging. 2021;9(3):141-148. doi: 10.11648/j.ijmi.20210903.12

Copy | Download

@article{10.11648/j.ijmi.20210903.12,
  author = {Fang Luo and Jun Chen and Shan Wu and Shan He},
  title = {Ultrasonographic Characteristics of Cervical Nerve Roots in Patients with the Degeneration of Cervical Vertebra},
  journal = {International Journal of Medical Imaging},
  volume = {9},
  number = {3},
  pages = {141-148},
  doi = {10.11648/j.ijmi.20210903.12},
  url = {https://doi.org/10.11648/j.ijmi.20210903.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20210903.12},
  abstract = {Background: Brachial plexus injury is a complex nerve injury. This may be due to the anatomical complexity of the brachial plexus. Purpose: To obtain sonographic characteristics and oblique sagittal diameter of cervical nerve root by high frequency ultrasound, and the morphology of brachial plexus was described. Methods: Two hundred and twenty-one subjects were recruited in our ultrasonography laboratory between March and December 2016. Their ultrasonographic characteristics of bilateral brachial plexus and cervical nerve roots were obtained by ultrasound, and they were measured with high echo sites on the bone cortex of anterior or posterior tubercles as positioning points in oblique sagittal. Results: 1. Cross-sectional sonogram of brachial plexus showed round and (or) oval “uniform” hypoechoic masses in the gap between anterior scalene muscle with middle scalene muscle, which were arranged in an arc shape; uniform low echo detected in short axis section and long axis section imaging of nerve bundles, which were wrapped by slightly hyper echoic epineuria. 2. Ultrasonographic imaging demonstrated that cervical nerve roots arranged between anterior tubercle and posterior tubercle, and the displaying rate of nerve roots of C4 to C7 was 100%; the displaying rate of nerve root of C8 was 78%. 3. Normal values of the diameters of cervicalr root nerves at intervertebral foramen were: C4, 2.65±0.27 mm; C5, 3.33±0.33 mm; C6, 3.76±0.36 mm; C7, 4.84±0.30 mm; C8, 3.48±0.34 mm. Conclusion: 1. Oblique sagittal imaging, nerve root of C7 is the thickest among all nerve roots of all examinee; 2. The diameter that of cervical nerve root of C4 may be positively correlated with the height.},
 year = {2021}
}

Copy | Download