Compression of brachial plexus as a diagnostic test of cervical cord lesion.

Abstract

This study evaluated the clinical significance of radicular signs around the neck in relation to mechanical lesions of the cervical spine and cord. Classical radicular signs around the neck, such as Jackson's sign or Spurling's sign, are not sensitive enough to detect corresponding lesions. Compression of the brachial plexus elicits radiating pain (BP) in patients with cervical lesions. The clinical significance of this new sign as a potential indicator of the cervical lesion compared with other classical signs was evaluated. Sixty-five patients who underwent magnetic resonance imaging of the cervical spine were prospectively evaluated for these clinical signs that elicit radiating pain around the neck. Clinical signs were correlated to deformity of the cervical spine and cord and to final diagnosis. Classical radicular signs often were lacking, even in patients with mechanical lesions around the cervical spine. However, BP was often observed in these patients. Compared with the classical radicular signs, BP is highly sensitive and reasonably specific in detecting mechanical lesions around the cervical spine, and suggests radicular involvement.