Cervical radiculopathy is a condition of the spine that occurs when there is damage, irritation or inflammation of the cervical nerve root causing pain or other neurological symptoms. In medical terminology, the spine is divided into regions that correspond to their position along the vertebrae in the backbone. These sections are:
- Cervical vertebrae in the neck (C1-C7)
- Thoracic vertebrae in the upper back (T1-T12)
- Lumbar vertebrae in the lower back (L1-L5)
- Sacral vertebrae in the pelvic region (S1-S5)
If a nerve root in any area of the seven cervical vertebrae is compressed or irritated, pain can radiate from the affected nerve creating symptoms accordingly. Symptoms can vary widely based upon which nerve is affected. For example, the most common type of radiculopathy affecting C7 can create pain and weakness radiating from the neck to the triceps, hands and the middle finger. Another common cervical radiculopathy diagnosis in C6 can present as radiating pain from the biceps to the wrists and the thumb/index finger. Compression in other sections of the cervical spine can create pain in the shoulder blades, upper arms and other fingers.
Causes of Cervical Radiculopathy
Cervical radiculopathy is caused by any condition that compresses or irritates the cervical nerve. Commonly, bone spurs from arthritis develop as the body tries to strengthen weak areas of the spine that occur as a person ages. These bone spurs can then pinch the nerve root. Among the most common causes of cervical radiculopathy include cervical herniated disc, cervical spinal stenosis, cervical degenerative disc, and less commonly, tumors of the spine or infections.
Symptoms of Cervical Radiculopathy
Patients most commonly report symptoms of pain, weakness, numbness and/or loss of function in areas that correspond with the affected nerve root in the neck, shoulder, arm, wrist, hand and fingers. Pain may be described as occurring only during certain movements, or as a constant radiating pain as follows:
- Sharp or burning pain that travels down the arm in the area of the involved nerve
- Numbness or a "pins and needles" sensation
- A feeling of weakness with certain activities
The spine experts at Mischer Neuroscience Institute utilize a variety of the most state-of-the-art equipment to diagnose cervical radiculopathy, with advanced technology that can help locate the precise cervical area where neurologic compression originates and detect the underlying causing conditions. Diagnostic tests may include:
- CT scan
Treatment of Cervical Radiculopathy
A variety of treatment options are available to successfully treat this condition in most patients without surgery, and include:
- Soft collar (to rest the muscles of the neck)
- Physical therapy/rehabilitation
- Medications such as non-steroidal anti-inflammatory drugs (NSAIDS)
- Epidural steroid injections or nerve root injections
For those patients who continue to experience significant pain, weakness and other symptoms after exhausting other treatment options, the following surgical interventions may be recommended:
Anterior Cervical Discectomy and Fusion (ACDF)
When a herniated or degenerative disc is the cause of cervical radiculopathy, our expert team of surgeons may perform ACDF, in which the offending disc is removed through the front of the neck and the spine is stabilized by fusion. As one of the most common surgical treatments for cervical radiculopathy, this anterior approach has been shown to result in less perioperative pain. It also provides the surgeon with better access to the spine wherein the disc can be removed without disturbing the spinal cord and nerves.
Once the disc has been removed, the surgeon then fills the open disc space with a bone graft either from the patient’s hip, a bone from a cadaver donor, or a bone graft substitute. The bone graft serves as a bridge for the vertebrae for stabilization, and the two fuse together over the next several weeks or months to form a solid bone.
Posterior Cervical Laminoforaminotomy
Posterior Cervical Laminoforaminotomy (PCL) is a surgical procedure that can be very effective in treating the pain that is caused by cervical radiculopathy that occurs from herniated discs or bone spurs. Unlike ACDF, spinal fusion is not required and therefore, recovery is quicker. It may be performed by minimally invasive techniques or by open surgery depending upon the severity of pressure on the nerves.
During a PCL, the surgeon makes an incision in the back (posterior) of the neck and shaves a small amount of bone from the lamina, which is the part of the spine that forms the arch on the back of the spinal canal. This provides better access to the damaged nerve so the surgeon can then remove the bone spurs and/or portion of the disc that is pressing on the nerve root.
Artificial Disk Replacement
Artificial Disk Replacement is a surgical technique used to treat cervical radiculopathy in which an incision is made in the front (anterior) of the neck to remove the offending disk and replace it with an artificial version. This method helps to restore space between the vertebrae to relieve pressure on the nerve root while creating stability in the spine. The artificial disk is custom-fitted and made of metal and plastic, which helps to restore and maintain flexibility and range of motion in the spine.
An injury near the root of a spinal nerve, or a pinched nerve, can cause neck pain that may
radiate into the shoulder and arm. Cervical radiculopathy is the medical term
for this condition.
Bone spurs develop as the body tries to strengthen weak areas of the spine that occur as a person ages. These bone spurs can then pinch the nerve root.
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