Purpose <p>Neurological complications are among the most significant concerns in cervical scoliosis (CS) surgery. The potential for plexus tethering and nerve root damage during corrective manoeuvres is barely explored to date. In this biomechanical study, tension exerted on the brachial plexus (BRP) nerve roots during different degrees of coronal correction was simulated in cadaveric specimens and interpreted in perspective of a narrative review.</p> Methods <p>On six cadaveric specimens, C2-T6 instrumentation was performed and nerve roots C5-C8 were bilaterally dissected. Changes of root length were measured at 0°, 40° and 80° of coronal alignment, while the corrective manoeuvre was performed through osteotomy and with center of rotation (COR) at C4-5 (COR C4-5) or at T2-3 (COR T2-3), respectively. To analyze statistical differences among tests, nerve elongation (NEL, mm) was used as an output variable.</p> Results <p>With increasing degree of coronal correction, NEL increased significantly for the upper and middle trunk (C5-6, and C7) of the BRP on the convex side of the construct. The increase was greater when the correction was performed with COR T2-3 compared to COR C4-5 and correlated with the advancement of correction from 40° to 80°. Results are highlighted in perspective of literature, stressing that precautions during planning and while performing CS surgery must be taken to prevent root injuries.</p> Conclusion <p>This anatomical study demonstrates the spatial changes of the BRP nerve roots during corrective manoeuvres used in CS surgery. With increasing degree of coronal correction, tension on the underlying nerve roots increases, conferring an increased neurologic risk. Results of this study add information to clinical rationales to improve safety with surgical correction of CS.</p>