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. 2022 Dec;19(4):1006-1012.
doi: 10.14245/ns.2244194.097. Epub 2022 Dec 31.

Reliability and Diagnostic Accuracy of Standard Dermatomes and Myotomes for Determining the Pathologic Level in Surgically Verified Patients With Cervical Radiculopathy

Chul Gie Hong  1 , Woo Dong Nam  1
Affiliations

Reliability and Diagnostic Accuracy of Standard Dermatomes and Myotomes for Determining the Pathologic Level in Surgically Verified Patients With Cervical Radiculopathy

Chul Gie Hong et al. Neurospine. 2022 Dec.

Abstract

Objective: This study aimed to investigate the reliability and diagnostic accuracy of typical dermatomes and myotomes for determining the pathologic level in surgically verified patients with cervical radiculopathy.

Methods: Patients who underwent single-level surgery due to cervical radiculopathy with at least a 60% reduction in preoperative symptoms or recovery of muscle power after surgery were included. The observed clinical symptoms (pain, paresthesia, motor weakness) were compared to those of typical cervical dermatomes and myotomes.

Results: Among the 227 patients reviewed, 142 (62.6%) had a standard dermatomal pattern, and 74 of 110 (67.3%) had a standard myotomal pattern. The myotome of C5/6 radiculopathy showed much more variance than those of other cervical segments. Among the patients with severe motor weakness (muscle strength ≤ grade 3 or obvious muscle atrophy), all those with involvement of root C5, C7, and C8 showed a typical pattern (C4/5: 13 of 13 patients, C6/7: 5 of 5 patients, C7/T1: 3 of 3 patients), while only 2 of the 6 patients (33.3%) with severe motor weakness caused by C5/6 radiculopathy fit the typical pattern.

Conclusion: Among various symptoms, cervical myotome is of great value in determining the pathological level. However, it should be noted that there is high variability in human dermatomes and myotomes, especially for motor weakness due to C6 root compression, which is more variable than others.

Keywords: Cervical pain; Cervical radiculopathy; Nerve root compression; Spinal disease.

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Conflict of interest statement

Conflict of Interest

The authors have nothing to disclose.

Figures

Fig. 1.
Fig. 1.
Dermatomes diagram demonstrates the dermatomal map of radiating arm pain (A) and axial neck pain including neck, scapular, interscapular (B). The red X marks indicate the location of the patient’s reported pain.
Fig. 2.
Fig. 2.
Distribution of various dermatomal patterns caused by compression of roots C5, C6, C7, and C8 in this study. NS, nonspecific.
Fig. 3.
Fig. 3.
Distribution of motor weakness patterns caused by compression of roots C5, C6, C7, and C8 in this study.
Fig. 4.
Fig. 4.
Distribution of various motor weakness patterns among patients with severe motor weakness.
See this image and copyright information in PMC

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