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Cervical spinal nerve 4, also called C4, is a spinal nerve of the cervical segment. It originates from the spinal cord above the 4th cervical vertebra (C4). It contributes nerve fibers to the phrenic nerve , the motor nerve to the thoracoabdominal diaphragm .
Central cord syndrome (CCS) is the most common form of cervical spinal cord injury (SCI). It is characterized by loss of power and sensation in arms and hands. It usually results from trauma which causes damage to the neck, leading to major injury to the central corticospinal tract of the spinal cord. [1]
A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. [1] [2] These are grouped into the corresponding cervical, thoracic, lumbar, sacral and coccygeal regions of the spine. [1]
Injuries to the cervical spine are common at the level of the second cervical vertebrae, but neurological injury is uncommon. C4 and C5 are the areas that see the highest amount of cervical spine trauma. [8]
Within the cervical spine, most joints are innervated by the medial branch nerve (a branch of the dorsal rami) from the same levels. In other words, the facet joint between C4 and C5 vertebral segments is innervated by the C4 and C5 medial branch nerves. However, there are two exceptions:
There is loss of sensation of pain, temperature, light touch, and pressure below the level of injury. [26] The spinal tracts that serve the arms are more affected due to their central location in the spinal cord, while the corticospinal fibers destined for the legs are spared due to their more external location. [26]
Moderate to severe spinal stenosis at the levels of L3/4 and L4/5 [further explanation needed] The diagnosis of spinal stenosis involves a complete evaluation of the spine. The process usually begins with a medical history and physical examination. X-ray and MRI scans are typically used to determine the extent and location of the nerve compression.
Suprascapular paralysis, causing back pain, problems with abduction and external rotation of the humerus, and wasting away of supraspinatus and infraspinatus. Supraspinatus muscle helps in 0°-15° arm abduction. And Infraspinatus helps in lateral rotation (external rotation) of humerus.
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