Cervical roots as origin of pain in the neck or scapular regions

Study Design. A prospective observational study. Objectives. To determine whether the pain in the neck or scapular regions in patients with cervical radiculopathy originates from the compressed root and whether the site of pain is useful for diagnosing the level. Summary of Background Data. The pain has been thought to be caused not by root compression but by instability caused by disc degeneration or zygapophysial joint osteoarthritis because it usually precedes radicular symptoms in the arm/fingers. Methods. The subjects were 50 consecutive patients with pain as well as arm/finger symptoms, who underwent single-root decompression alone. The involved roots were C5 in 9 patients, C6 in 14, C7 in 14, and C8 in 13. Results. The pain preceded the arm/fingers symptoms in 35 patients (70%). Although the pain had lasted for more than 7 months on average before surgery, it was relieved early after surgery in 46 patients (92%). When the painful site was suprascapular, C5 or C6 radiculopathy was frequent (P < 0.01). When it was interscapular, C7 or C8 radiculopathy was frequent (P < 0.001). When it was scapular, C8 radiculopathy was frequent (P < 0.01). Conclusions. Pain in the suprascapular, interscapular, or scapular regions can originate directly in the compressed root. The site of the pain is valuable for determining localization of the involved root.