Comparison of the Cross-Sectional Area of Longus Colli Muscle Between Patients With Cervical Radicular Pain and Healthy Controls

Background: Previous studies have shown atrophy of paravertebral lumbar muscles in patients with lumbar radicular pain and have proposed rehabilitative approaches based on these findings. However, changes in cervical paravertebral muscles in patients with cervical radicular pain are still unknown.

Objective: The aim of this study was to compare the cross-sectional area (CSA) of the longus colli muscle (LCM) in patients with cervical radicular pain and healthy controls via ultrasound measurement.

Study design: Case-control study.

Setting: Outpatients who came for treatment to the neurosurgery clinic.

Participants: A total of 20 patients with more than 4 weeks of cervical radicular pain and 20 healthy matched (for body mass index, age, and gender) control subjects.

Interventions: Ultrasound measurements.

Main outcome measures: The CSA of the LCM at the level of C5-C6 was measured by ultrasound with the subject in supine position. Also, Neck Disability Index (NDI), and visual analogue scale (VAS) scores were reported by patients. An independent-sample t test was used for investigation of differences in CSA and other variables in both groups.

Results: A total of 20 patients with cervical radicular pain with a mean age of 42.4 years (standard deviation [SD] = 7 years) and 20 healthy matched controls with mean age of 40.7 years (SD = 7 years) participated in the study. Patients with cervical radicular pain showed smaller CSA of the LCM bilaterally compared with controls (mean difference: 0.37 [SD = 0.15]; P < .001). In the patient group, there were no significant differences between the CSA of the LCM in the involved and noninvolved sides. No correlations between the CSA of the LCM and VAS, Neck Disability Index, symptom duration, gender, BMI, and age of the patients were found.

Conclusions: This is the first study to show via ultrasound assessment that patients with cervical radicular pain had smaller bilateral CSA of the LCM in comparison with healthy controls. It is also not clear whether atrophy of the LCM in patients with cervical radicular pain is a consequence or a cause of the pain. Reduction in the stability of the neck due to atrophy of the LCM could make the cervical spine region susceptible to more injuries, which might be prevented by functional and strengthening exercises.

Level of evidence: III.