Could Cervical Postural Changes Affect the Long Thoracic Nerve Electromyographic Findings?

NCT ID: NCT02639104

Last Updated: 2015-12-28

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-12-31
• Study Completion Date: 2016-04-30

Brief Summary

This study investigates one of the mechanism factors of neck pain. Cervical lordotic angle alterations affect the tension of serratus anterior muscle. Expected result that the long thoracic nerve can be affected in this situation, and could be observed the functional changes of the nerve with serratus anterior electromyographic findings.

Detailed Description

Different methods exist in order to evaluate muscle function. For the neck pain, the most commonly used method by researchers and clinicians are spot radiography and surface electromyography (sEMG). Radiographs can be used for the kyphotic angle or cervical lordotic angle measurements. Parameters that can be studied by EMG are amplitude, timing, conduction velocity, fatigability and characteristic frequencies/patterns.

The long thoracic nerve innervates the serratus anterior muscle. This nerve arises from the anterior rami of three spinal nerve roots: the fifth, sixth, and seventh cervical nerves (C5-C7) The nerve descends through the cervicoaxillary canal behind (posterior to) the brachial plexus and the axillary artery and vein, resting on the outer surface of the serratus anterior. The Serratus anterior electromyography, the needle can be inserted into the muscle superficially to the fourth to sixth rib in the medial or posterior axillary line. The usual nerve latency time is between 2.6-4 ms.

In this study, the results of serratus anterior muscle EMG activity and postural cervical angle alterations (lateral radiography) in patients with chronic mechanical neck pain will be compared with healthy volunteers without neck pain.

Conditions

Cervicalgia

Keywords

neck pain; cervical lordosis; long thoracic nerve

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Cervical postural related neck pain

Patients recruit in this group who has a neck pain without radiculopathy. If the patient examination shows neurologic deficits, this patient will exclude in this study. All patients will undergo lateral cervical spine spot radiography and serratus anterior needle electromyography. Cervical segmental angle measurements will be done in all patients.

Group Type: EXPERIMENTAL

Radiography

Intervention Type: RADIATION

Obtaining patients lateral spot cervical spine radiography and will measure;

1. The segmental angle will be measured from C2-C7 inferior endplates on the lateral radiography

2. If there is a segmental kyphosis (for example kyphotic angle in C4-5 level), the segmental cobb angle will be measured in the level of the main kyphosis

3. The segmental cobb angle will be measured between C2-C4 inferior endplates and C4-C7 inferior endplates

Electromyography

Intervention Type: OTHER

Serratus anterior needle electromyography:

The needle can be inserted into the muscle superficially to the fourth to sixth rib in the medial or posterior axillary line. The usual nerve latency time is between 2.6-4 ms.

Control group

The healthy volunteers recruit in this group. All inviduals will undergo lateral cervical spot radiography and serratus anterior needle electromypography

Group Type: SHAM_COMPARATOR

Radiography

Intervention Type: RADIATION

Obtaining patients lateral spot cervical spine radiography and will measure;

1. The segmental angle will be measured from C2-C7 inferior endplates on the lateral radiography

2. If there is a segmental kyphosis (for example kyphotic angle in C4-5 level), the segmental cobb angle will be measured in the level of the main kyphosis

3. The segmental cobb angle will be measured between C2-C4 inferior endplates and C4-C7 inferior endplates

Electromyography

Intervention Type: OTHER

Serratus anterior needle electromyography:

The needle can be inserted into the muscle superficially to the fourth to sixth rib in the medial or posterior axillary line. The usual nerve latency time is between 2.6-4 ms.

Interventions

Radiography

Obtaining patients lateral spot cervical spine radiography and will measure;

1. The segmental angle will be measured from C2-C7 inferior endplates on the lateral radiography

2. If there is a segmental kyphosis (for example kyphotic angle in C4-5 level), the segmental cobb angle will be measured in the level of the main kyphosis

3. The segmental cobb angle will be measured between C2-C4 inferior endplates and C4-C7 inferior endplates

Intervention Type: RADIATION

Electromyography

Serratus anterior needle electromyography:

The needle can be inserted into the muscle superficially to the fourth to sixth rib in the medial or posterior axillary line. The usual nerve latency time is between 2.6-4 ms.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patient whose age is > to 18 years and <40 yo
• Patient presenting a chronic neck pain (symptoms over 3 months)
• No neurological deficit
• Asymptomatic volunteers (for control group)
• Obtaining the enlightened consent of the patient

Exclusion Criteria

• Patient having refused to sign his consent
• Patients whose age is < to 18 years or >40 yo.
• Patients with neurologic deficits
• Patients presenting history of allergy
• History of cervical spine surgery
• Patient presenting an anticoagulant or salicylated treatment which can not be interrupted.
• Pregnant woman.
• Patient with acute head and neck trauma
• Patient with a contra-indication to radiography.
• Patient with a psychiatric pathology preventing a clinical evaluation.
• Patient with contra-indication (cutaneous or different) to needle electromyography.
• Surgery contra-indication (cardiac failure, respiratory…)
• Patient without health coverage.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Baskent University

OTHER

Sponsor Role: lead

Responsible Party

Atilla Kircelli

M.D.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Cem Yılmaz, M.D.

Role: STUDY_DIRECTOR

Baskent University, Department of Neurosurgery

Locations

Baskent University Konya Hospital

Konya, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Castelein B, Cools A, Bostyn E, Delemarre J, Lemahieu T, Cagnie B. Analysis of scapular muscle EMG activity in patients with idiopathic neck pain: a systematic review. J Electromyogr Kinesiol. 2015 Apr;25(2):371-86. doi: 10.1016/j.jelekin.2015.01.006. Epub 2015 Jan 31.

Reference Type: RESULT

PMID: 25683111 (View on PubMed)

Other Identifiers

KA15-220

Identifier Type: -

Identifier Source: org_study_id