The cutaneous silent period is preserved in cervical radiculopathy: signiﬁcance for the diagnosis of cervical myelopathy

Eur Spine J, 2011 · DOI: 10.1007/s00586-010-1627-z · Published: December 5, 2010

Simple Explanation

The cutaneous silent period (CSP) is a temporary pause in muscle activity after a brief, painful stimulus to the fingertip. This study aimed to see if nerve root compression (radiculopathy) affects the CSP, as this could impact the CSP's usefulness in diagnosing spinal cord problems (myelopathy). The study found that the CSP remains intact even in the presence of radiculopathy, likely because the nerve fibers responsible for the CSP are more resistant to damage.

Study Duration

Not specified

Participants

23 patients with cervical radiculopathy

Evidence Level

Not specified

Key Findings

1
The cutaneous silent period (CSP) was preserved in most patients with cervical radiculopathy, regardless of which finger was stimulated.
2
CSP onset latency, endpoint latency, and duration did not differ significantly between thumb, middle finger, and little finger stimulation in patients with C6, C7, and C8 radiculopathies.
3
Afferent fibers responsible for eliciting the CSP appear to be relatively less affected by injury or disease that may significantly impair conduction along large afferent fibers.

Research Summary

This study investigated the effect of cervical radiculopathy on the cutaneous silent period (CSP), an electrophysiological measure of spinal inhibitory reflexes. The results showed that the CSP is preserved in patients with cervical radiculopathy, suggesting that the afferent A-delta fibers responsible for the CSP are not significantly affected by nerve root compression. This finding supports the use of CSP as a specific tool for diagnosing cervical myelopathy, as it is not confounded by the presence of radiculopathy.

Practical Implications

Diagnostic Specificity

CSP alterations can be more confidently attributed to myelopathy rather than radiculopathy.

Clinical Utility

CSP can be adopted as a physiological aid in diagnosing spinal cord dysfunction.

Research Tool

CSP can be used in future studies to further investigate spinal cord pathologies.

Study Limitations

1
Severity of the root lesion was not graded.
2
Correlation with imaging studies was not performed.
3
Averaging a greater number of trials may have revealed subtle differences in CSP parameters.

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