Differentiation of cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy

Abstract

Objective To assess reason of misdiagnosis of cervical nerveentrapment syndrome at extravetebral foramen as cervical spondylopathy and their differentiation. Methods 44 cases of cervical nerve entrapment syndrome at extravetebral foramen misdiagnosed as cervical spondylopathy were involved in the study. Differential characteristics showed as follows : (1) Cervical spondylopathy : it was most commonly seen at middle aged and senile patients. The principal symptoms were aching pain at cervical part and shoulder, special pain occurring when rotation of cervical part at a certain angle and patient’s not knowing where to right put his head and neck. Sign presented as tenderness at interspinal areas , sensory disturbance at 1 or 2 nerve root(s) distributing areas and occasionally at posterosuperior medial aspect. Local block at tenderness point at cervical part was inefficient. (2) Cervical nerve entrapment syndrome at extravertebral foramen: it occurred in senile, middle aged , juvernile and adolescent patients. The main symptoms were discomfort at cervical and shoulder areas, tingling of extremity and patients not knowing where to pose his upper extremity. Significant pressure pain point occurred at middle point of posterior edge of sternoleidomastoid muscle. There was pressure pain point at the back at the lateral part of spine, radiating at affected part. Sensory disturbance included commonly C1 to T1 innervating areas and commonly in combination with postosuperior medial aspect of forearm and the face . Immediate efficiency occurred after local block at tenderness point at neck with improved sensation and muscle strength. Results Diagnosing treatment ,i.e. local block of tenderness at neck , was an important procedure for differentiating cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy. Conclusions Cervical nerve entrapment syndrome at extravertebral foramen was commonly confused with cervical spondylopathy . It was importance for their differential diagnosis. Key words: Thorocic outlet syndrome; Cervical vertebrae; Intervertebral diskdisplacement; Diagnosis,Differential