The importance of cervical myelography in cervical and upper throacic nerve root avulsion.

Abstract

Injury to the brachial plexus is not uncommon. In infants it is seen as a birth palsy, usually involving the fifth and sixth cervical roots (5). In adults it occurs most frequently following trauma to the shoulder region in which stress traction has been placed on the involved roots. The term avulsion is reserved for intraspinal separation of the nerve root from the cord. Separation elsewhere as the result of blunt or closed trauma constitutes extraspinal or peripheral rupture (1, 5). The mechanism of occurrence, clinical features, treatment, and myelographic findings in brachial plexus avulsion will be considered here and 3 cases will be reported. Mechanisms of Injury Barnes (2) gives an excellent discourse on the probable mechanism of brachial plexus injury. The head and shoulder are separated forcibly, the position of the arm determining the type of injury. When the arm is in adduction, the greater stress is placed on the upper roots (C-5 and C-6), resulting in an Erb type of paralysis. With the arm in...