Upper limb neurodynamic mobilization disperses intraneural fluid in cervical nerve roots: A human cadaveric investigation

• Published in: Musculoskeletal science & practice 2023-11, Vol.68, p.102876-102876, Article 102876
• Main Authors: Burgess, Nathan E, Gilbert, Kerry K, Sobczak, Stéphane, Sizer, Phil S, Homen, Dylan, Lierly, Micah, Kearns, Gary A, Brismée, Jean-Michel
• Format: Article
• Language: English
• Subjects: Cadaver; Cervical Vertebrae; Humans; Radiculopathy - therapy; Spinal Nerve Roots - physiology; Upper Extremity
• ISSN: 2468-7812; 2468-7812
• DOI: 10.1016/j.msksp.2023.102876

Cervical radiculopathy is a common cause of neck pain with resultant intraneural edema and impaired nerve function. One strategy to treat radiculopathy is neurodynamic mobilization (NDM); however, little is known about the effect of this treatment on nerve tissue fluid dynamics. Investigate the impact of upper limb, median nerve-biased NDM on longitudinal intraneural fluid dispersion in the C5,C6,C7 nerve roots in un-embalmed cadavers. In situ repeated measures. Human cadavers (n = 8) were dissected to expose and inject C5,C6,C7 cervical nerve roots with a dying agent. Initial longitudinal dye spread was recorded after dye spread stabilization. Cadavers were taken through 150 repetitions of upper limb, median nerve-biased NDM followed by dye spread re-measurement. Paired-samples t-tests with Bonferroni correction (α = 0.017) were used to compare pre-vs post-NDM dye spread measurements at C5,C6,C7 nerve roots; a one-way repeated measures ANOVA (α = 0.05) was used to examine differences between change scores for C5,C6,C7 nerve roots. Median nerve-biased NDM resulted in significant intraneural longitudinal dye spread at C5 and C6 nerve roots of 0.6 ± 0.6 mm and 3.4 ± 3.9 mm, respectively (p