Observed Patterns of Cervical Radiculopathy: How Often Do They Differ From a Standard, “Netter Diagram” Distribution?
SOURCE: Spine J. 2019 (Jul); 19 (7): 1137–1142
Steven J. McAnany MD , John M. Rhee MD , Evan O. Baird MD , Weilong Shi MD , Jeffrey Konopka MD , Thomas M. Neustein MD , Rafael Arceo MD
Department of Orthopedic Surgery,
Hospital for Special Surgery,
535 East 70th St,
New York, NY 10021, USA.
BACKGROUND CONTEXT: Traditionally, cervical radiculopathy is thought to present with symptoms and signs in a standard, textbook, reproducible pattern as seen in a “Netter diagram.” To date, no study has directly examined cervical radicular patterns attributable to single level pathology in patients undergoing ACDF.
PURPOSE: The purpose of this study is to examine cervical radiculopathy patterns in a surgical population and determine how often patients present with the standard textbook (ie, Netter diagram) versus nonstandard patterns.
STUDY DESIGN/SETTING: A retrospective study.
PATIENT SAMPLE: Patients who had single-level radiculopathy with at least 75% improvement of preoperative symptoms following ACDF were included.
OUTCOME MEASURES: Epidemiologic variables were collected including age, sex, weight, body mass index, laterality of symptoms, duration of symptoms prior to operative intervention, and the presence of diabetes mellitus. The observed pattern of radiculopathy at presentation, including associated neck, shoulder, upper arm, forearm, and hand pain and/or numbness, was determined from chart review and patient-derived pain diagrams.
METHODS: We identified all patients with single level cervical radiculopathy operated on between March 2011 and March 2016 by six surgeons. The observed pattern of radiculopathy was compared to a standard textbook pattern of radiculopathy that strictly adheres to a dermatomal map Fisher exact test was used to analyze categorical data and Student t test was used for continuous variables.
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