Ultrasound reference values of C5, C6, and C7 brachial plexus roots at the interscalene groove
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ORIGINAL ARTICLE
Ultrasound reference values of C5, C6, and C7 brachial plexus roots at the interscalene groove Mohamed A. Bedewi 1
&
Mamdouh A. Kotb 2,3
Received: 15 July 2019 / Accepted: 15 October 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objectives The objective of this study is to estimate the reference values of the brachial plexus roots at the interscalene groove. The physical and demographic characteristics of 59 healthy adult volunteers were studied. The CSA reference values and their correlations with weight, height, age, body mass index (BMI). Methods Fifty nine (27 males, 32 females) subjects were enrolled in the study. The mean cross sectional area of C5, C6 and C7 nerve roots were obtained. Results The mean CSA of the brachial plexus roots was as follows: C5 nerve root was 5.1 mm2 (range 1.7–11.1 ± 1.9 SD), C6 nerve root CSA 5.8 mm2 (range 1.7–12 ± 2.4 SD), and C7 nerve root 6.3 (range 1.6–19.6 ± 3.4 SD). There was a significant statistical difference between both sexes in our study. No statistical significant difference in tissue stiffness between dominant and nondominant hands. No statistical correlation was found between the CSA of the cervical nerve roots and different demographic factors. There was a positive statistical correlation between the CSA of C5 and both C6 and C7 nerve roots. Also positive significant statistical correlation was noted between the CSA of C6 and C7 nerve roots. Conclusion The CSA reference values of the C5-C7 nerve roots has been determined in asymptomatic individuals and can serve as a reference when studying pathological conditions of these structures. Keywords Brachial plexus . Ultrasound . Reference values . Nerves
Abbreviations CSA Cross-sectional area BMI Body mass index
Introduction In the last 10 years, high-resolution ultrasound was introduced as an efficient and safe diagnostic tool for the diagnosis of
* Mohamed A. Bedewi [email protected] 1
Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz university, Al-kharj, Kingdom of Saudi Arabia
2
Neurology Department, College of Medicine, Prince Sattam Bin Abdulaziz university, Al-Kharj, Kingdom of Saudi Arabia
3
Neurology Department, Faculty of Medicine, Minia University, Minia, Egypt
different types of peripheral nerve injuries. The brachial plexus is a significant part of the peripheral nervous system, as it provides both the sensori and motor supply of the upper limb. The interscalene area is involved by many lesions including traumatic and nontraumatic pathologies. The roots of the brachial plexus originate from the ventral parts of the C5, C6, and C7 spinal nerves, in addition to C8 and T1 spinal nerves. Three of these are shown clearly by ultrasound in the interscalene groove, between the anterior and the middle scalene muscles. The C5 and C6 nerve roots exit between the well-formed anterior and posterior tubercles of the transverse process. The C7 nerve root emerges related to a prominent posterior tubercle and a rudimentary anterior tuberc
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