Cervical Radiculopathy

Cervical radiculopathy is a condition resulting from a compressed nerve in the cervical spine or neck. The usual cause for such symptoms is progressive wear of tear in the disc. This results in a disc prolapse that causes compression on to the nerve. Cervical radiculopathy can also result from osteoarthritic bony spurs. This narrows the foramina canals through which the nerves exit the cervical spinal cord.

Cervical Radiculopathy Symptoms

The symptoms are usually neck pain and a sharp pain down the arm. These symptoms can be of a gradual onset or come on quite quickly. It is not unusual for the symptoms of neck pain and arm pain to come on together or one symptom to preceed the other.  The duration of symptom is also variable.

The distribution of pain depends on the nerve root or roots that are being compressed. Other more severe symptoms like numbness, tingling or pins and needles may occur. This relates to the severity of the nerve compression.

Cervical Radiculopathy Diagnosis

Diagnosis is made by analysing the history and clinical examination of the patient. We then correlate this with the diagnostic imaging. The imaging test of choice is the MRI scan.

Cervical Radiculopathy Treatment

The majority of patients find that the condition does resolve by itself overtime. During this period, the type of treatment is pain relieving medication and gentle physiotherapy.

However, surgery becomes the treatment option for:

  • patients who do not respond this initial line of treatment
  • patients who have a large disc bulge with the potential of causing nerve or spinal cord damage
  • patients who have numbness or weakness secondary to nerve injury

The treatment options for cervical disc prolapse are either anterior or posterior surgery. This will depend on the location where the nerve is compressed and also the findings of the scan.

Operations

The types of operations are:

    1. Anterior Cervical Discectomy and Fusion


    1. Disc Replacement Surgery


Patients who have cervical canal stenosis might be candidates for cervical laminectomies or cervical foraminotomies.


Young patients who have disc prolapse without any significant bony changes can undergo a cervical disc replacement. This treatment is thought to be beneficial as it addresses the symptoms and also helps to avoid accelerated wear and tear in adjacent discs. Patients who have cervical fusion see more wear and tear at the adjacent segment.


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