Cervical Radiculopathy [spondylosis]

Cervical Radiculopathy [spondylosis]

What Is Cervical Radiculopathy?

Most oftenly misdiagnosed as cervical spondylosis by your treating doctor.

Cervical radiculopathy refers to damage or irritation of the nerve roots within the cervical or neck area. In general, symptoms associated with cervical radiculopathy are localized to the neck, chest, shoulders, arms, and upper back. Irritation and injury to the nerve roots within the cervical area can result in symptoms of pain and discomfort around the neck and upper extremities, along with motor dysfunction (e.g., muscle weakness) or sensory deficits (e.g., loss of sensation) in these areas. In some instances, individuals report sensations of numbness or tingling within the hands and fingers.

 

Previous work has provided support for favorable outcomes among individuals with cervical radiculopathy. An epidemiologic study that included a five-year follow-up survey reported that only 31.7% of patients with symptoms of cervical radiculopathy experienced symptom recurrence during that time.

First-line treatment for cervical radiculopathy generally includes an analgesic medication, which can include both steroids and non-steroid medication, and physical therapy. For patients with symptoms that do not remit after trying these methods or whose symptoms are more chronic in nature, more intensive procedures may be warranted.

Causes Of Cervical Radiculopathy

Symptoms of cervical radiculopathy are caused by compression of the nerve root within the cervical spine. Cervical nerves project from the cervical spine (i.e., the neck) at each of the seven cervical vertebrae. These nerves provide motor function to the fingers, hands, arms, and shoulders. Further, cervical nerves transmit sensory information back and forth between the skin and muscles in these areas, and the brain. Thus, cervical radiculopathy may occur at any of the seven locations along the cervical spine.

 

Compression of the cervical nerve roots can be caused by a number of different conditions. One of the most common of these conditions is cervical In between each of the vertebrae that comprise the cervical spine are intervertebral discs. These discs are constructed with a tough, fibrous outer layer and a soft, viscous gel inner layer. This allows them to act as shock absorbers for the vertebral bones. When the intervertebral discs become damaged or irritated they can herniate, or protrude, out. This disc herniation places pressure on the other structures within the cervical spine, including the root of the cervical nerve, causing the irritation associated with cervical radiculopathy.

Similarly, stenosis of the cervical spine can also lead to symptoms of cervical radiculopathy. This occurs when the cervical spine begins to undergo changes associated with degeneration. Often, the spaces within the spinal canal begin to tighten, which can place additional pressure on the cervical nerve root. Cervical degenerative disc disease can also lead to cervical radiculopathy. More specifically, when the discs of the cervical spine begin to degenerate over time they are at risk for pinching a cervical nerve.

Less common causes of cervical radiculopathy include tumors or spinal infections.

Cervical radiculopathy can be diagnosed through a variety of procedures. For instance, magnetic resonance imaging (MRI), computed tomographic myelography, and electromyography all may be employed to determine the presence of neurologic compression within the cervical area. Further, these procedures can also be used by physicians to check for the presence of other conditions that may account for the patient’s symptoms.

Other tests are available for diagnosing cervical radiculopathy, including the Spurling test (ST), the shoulder abduction test (SAT), and the upper limb tension test (ULTT). These are employed to assess nerve root pain.

Treatments For Cervical Radiculopathy

For most individuals with cervical radiculopathy, non-operative treatment methods can be highly effective. Common intervention recommendations include:

 

  • Immobilization using a cervical collar
  • Traction
  • Physical therapy and manipulation
  • Pharmacotherapy
  • Steroid injections.

Another method of treatment that has been shown to be effective in managing cervical radiculopathy pain is steroid injections. For instance, cervical perineural injections (including translaminar and transforaminal epidurals, and select deliver steroid medication to the affected nerve root, which reduces inflammation of the area, and an anesthetic, which helps to reduce or eliminate pain.

Conclusion

Cervical radiculopathy refers to the symptoms associated with damage or irritation to the cervical nerves. These symptoms can include pain and discomfort within the chest area, as well as the upper extremities. Other symptoms may include sensory deficits and motor difficulties. There are a variety of causes for cervical radiculopathy; however, a number of techniques are available to confirm the presence of neurologic compression within the cervical area.

 

Outcomes for patients with cervical radiculopathy are good. Treatment recommendations can range from immobilization to steroid injections.  To percutaneous discectomy.Many of the treatments available for the neurological pain associated with cervical radiculopathy are highly effective in providing symptom relief. Patients are encouraged to speak with their physician about these treatments, along with their associated risks and benefits