title: 2015 Young Investigator Award Winner: Cervical Nerve Root Displacement and Strain During Upper Limb Neural Tension Testing: Part 2: Role of Foraminal Ligaments in the Cervical Spine.
abstract: METHODS
  A cross-sectional cadaveric examination of the mechanical effect of foraminal ligaments on cervical nerve root displacement and strain.
  
  
  OBJECTIVE
  To determine the role of foraminal ligaments by examining differences in cervical nerve root displacement and strain during upper limb neural tension testing (ULNTT) before and after selective cutting of foraminal ligaments.
  
  
  BACKGROUND
  Although investigators have determined that lumbar spine foraminal ligaments limit displacement and strain of lumbosacral nerve roots, similar studies have not been conducted to prove that it is true for the cervical region. Because the size, shape, and orientation of cervical spine foraminal ligaments are similar to those in the lumbar spine, it is hypothesized that foraminal ligaments in the cervical spine will function in a similar fashion.
  
  
  METHODS
  Radiolucent markers were implanted into cervical nerve roots C5-C8 of 9 unembalmed cadavers. Posteroanterior fluoroscopic images were captured at resting and upper limb neural tension testing positioning before and after selective cutting of foraminal ligaments.
  
  
  RESULTS
  Selective cutting of foraminal ligaments resulted in significant increases in inferolateral displacement (average, 2.94 mm [ligaments intact]-3.87 mm [ligaments cut], P < 0.05) and strain (average, 9.33% [ligaments intact]-16.31% [ligaments cut], P < 0.03) of cervical nerve roots C5-C8 during upper limb neural tension testing.
  
  
  CONCLUSIONS
  Foraminal ligaments in the cervical spine limited cervical nerve root displacement and strain during upper limb neural tension testing. Foraminal ligaments seem to have a protective role, reducing displacement and strain to cervical nerve roots during tension events.
  
  
  METHODS
  2.
authors.affiliation: *Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ †Center for Rehabilitation Research and Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Lubbock, TX ‡Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Universite Libre de Bruxelles, Bruxelles, Belgium §Department of Medical Education, Albany Medical College, Albany, NY; and ¶Research Unit in Osteopathy, Universite Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Chelsea M
authors.initials: CM
authors.lastname: Lohman
authors.forename: Kerry K
authors.initials: KK
authors.lastname: Gilbert
authors.forename: Stéphane
authors.initials: S
authors.lastname: Sobczak
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Brismée
authors.forename: C Roger
authors.initials: CR
authors.lastname: James
authors.forename: Miles
authors.initials: M
authors.lastname: Day
authors.forename: Michael P
authors.initials: MP
authors.lastname: Smith
authors.forename: LesLee
authors.initials: L
authors.lastname: Taylor
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Dugailly
authors.forename: Timothy
authors.initials: T
authors.lastname: Pendergrass
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Sizer
mesh_terms: D001363:Awards and Prizes; D001696:Biomechanical Phenomena; D002102:Cadaver; D002574:Cervical Vertebrae; D057918:Fiducial Markers; D006801:Humans; D008022:Ligaments / Q000502:physiology*; D009068:Movement; D011859:Radiography; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging* / Q000502:physiology*; D013314:Stress, Mechanical; D034941:Upper Extremity / Q000502:physiology