DISTINCT MRI PHENOTYPES OF NEUROGENIC VS. NON-NEUROGENIC CERVICOBRACHIAL PAIN: A COMPARATIVE STUDY

Abstract

The differentiation of cervicobrachial pain into neurogenic and non-neurogenic etiology, is crucial for appropriate clinical management. A clear distinction based on objective findings can guide therapeutic strategies. The goal of this paper is to compare the demographic, anamnestic and magnetic resonance imaging (MRI) characteristics between patients with neurogenic and non-neurogenic cervicobrachial pain. This analytical, cross-sectional study included 130 patients with symptoms of cervicobrachial syndrome referred to cervical spine MRI. Based on radiological findings of nerve root or spinal cord compression, patients were divided into a neurogenic pain group (n=85) and a non-neurogenic pain group (n=45). Demographic and anamnestic data were collected via a questionnaire. Statistical analysis was performed using Student's t-test and the X²-test. The non-neurogenic pain group was significantly younger than the neurogenic group (mean age 39.0±13.5 vs. 46.5±12.9 years, p=0.0023). The history of a motor vehicle accident (MVA) was significantly more frequent in the neurogenic group (23.5% vs. 4.4%, p=0.0058). Advanced degenerative findings, such as spondylosis (58.8% vs. 4.4%, p<0.0001) and Modic changes (14.1% vs. 2.2%, p=0.031), were significantly more prevalent in the neurogenic group. Conversely, isolated disc dehydration was significantly more common in the non-neurogenic group (81.2% vs. 48.9%, p=0.00013). In conclusion, neurogenic and non-neurogenic cervicobrachial pain exhibit distinct demographic and radiological profiles. Neurogenic pain is associated with older age, a history of trauma and advanced degenerative changes. Non-neurogenic pain is more characteristic in younger patients, predominantly female, and is associated with early degenerative findings like disc dehydration.