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Additional benefit of ultrasonography to evaluate nerve root condition of degenerative cervical spine disease


Study design

A cross-sectional explanatory study.


To clarify the nerve root condition and the association between nerve root cross-sectional area (CA) on ultrasonography (US) and other examinations such as MRI or compound muscle action potentials (CMAPs) in degenerative cervical spine diseases.


A university hospital in Japan.


Fifty-one patients diagnosed with proximal cervical spondylotic amyotrophy (CSA) (13 patients), cervical radiculopathy of C5 or C6 nerve root (CR) (26 patients), or cervical spondylotic myelopathy (CSM) (12 patients), and twenty-nine healthy volunteers were included in this study. Neurological findings, US findings and CMAPs of deltoid and biceps muscles of all participants were evaluated. In addition, CSA, CR, and CSM patients underwent MRI.


A significant correlation was not observed between CA and CMAP amplitude or foraminal diameter on MRI (P > 0.05). In the US examination, the C6 CA of the affected side of the CR group was significantly larger than that of both the normal side and the other groups (P < 0.001). The C5 CA of the affected side of the CSA group clearly showed a bimodal distribution: enlarged and small CA groups. In the CMAP findings, CSA cases respectively showed the lower amplitude of deltoid and bicep CMAPs on both the normal and the affected side (P 0.01). CSM and healthy volunteers were nearly identical in CA and CMAPs.


Utilizing US in addition to NCS and MRI can contribute towards an evaluation of the nerve root condition of degenerative cervical spine disease.


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Fig. 1: Cross sectional area of C5 and C6 nerve root of each groups.
Fig. 2: A C6CR case.
Fig. 3: A CSA case.

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Authors and Affiliations



HK and NT were responsible for designing the study protocols, conducting the research, analyzing data, interpreting results, and writing the manuscript. NT, KK, NA, and RT were involved in recruiting patients and editing the manuscript. NT, KK, NA, RT, and MI reviewed the manuscript.

Corresponding author

Correspondence to Hiroki Kozuki.

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We obtained written informed consent from all participants and institutional review board approval for this study (IRB:30-156).

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Kozuki, H., Tadokoro, N., Aoyama, N. et al. Additional benefit of ultrasonography to evaluate nerve root condition of degenerative cervical spine disease. Spinal Cord 61, 69–75 (2023).

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