Cross-sectional Study of the Anatomic Variation of Brachial Plexus’ Nerve Roots Origin in Jordan: Prefixed and Postfixed
DOI:
https://doi.org/10.35516/jmj.v59i1.2033Keywords:
Brachial plexus, Prefixed, Postfixed, 3D NerveVIEW, Neuroanatomy, Spinal nervesAbstract
Background: Anatomical variations in the origin of brachial plexus
and the nerve roots contributing to it exist. Based on literature review, these
variations are not uncommon and may even be the rule rather than the exception.
However, data regarding these variations in the Jordanian population is absent,
and assessment of such variations is important in both clinical evaluation and
surgical procedures. Such anatomical variations may increase the likelihood of
specific pathologies, like thoracic outlet syndrome, and can influence the surgical
strategies employed for the brachial plexus. This study aimed to explore the
anatomy and variations of the brachial plexus’s origin in normal healthy
Jordanian subjects using magnetic resonance imaging (MRI), particularly
prefixed and postfixed variants.
Methods: This was a cross-sectional study. Random selection of
50 subjects undergoing cervical spine MRI, for which a 3D NerveVIEW sequence
of the brachial plexus nerve roots was performed in both coronal and axial planes.
For each subject, identification of the nerve root levels contributing to the
formation of the brachial plexus on each side was performed and
prefixed/postfixed variations were identified. Other measurements, diameter and
length of nerve roots, were identified, and a comparison of these measurements
between males and females in the studied population was performed.
Results: Out of the 94 brachial plexuses analyzed, 25 were prefixed (26.6%) and
none were postfixed. Those 25 prefixed plexuses were identified in 15 subjects;
10 subjects having the prefixed variant bilaterally (66.7% of all prefixed
plexuses), 4 subjects were left prefixed plexus (26.7%) and only one was a right
prefixed plexus (6.7%). Data analysis of the lengths and diameters of all nerve
roots contributing to the formation of the brachial plexuses in all subjects (n=94)
showed that the mean diameter and length of the left-sided roots were
significantly thicker and longer than their right-sided counterparts (p-values were
0.0178 and 0.0014, respectively). In addition, nerve roots contributing to brachial
plexuses formation were longer and wider in males than those in females.
Conclusions: This study concluded that anatomical variation of the nerve roots
contributing to brachial plexus is common among the Jordanian population,
particularly the pre-fixed variant.
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