Cervical Radiculopathy
- Home
- Cervical Radiculopathy
Cervical Radiculopathy
Cervical Disc Prolapse
Compression of the nerves that come from the neck to the upper limb can result in pain, numbness and weakness in the upper limb which is referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy. Patients develop neck pain that may radiate into the shoulder and arm. As the disks lose height, the vertebrae move closer together. The body sees the collapsed disk as a possible weak area and responds by forming more bone — called spurs — around the disk to strengthen it. Bone spurs may also narrow the area of the foramen and pinch the nerve root. The disk changes that occur with age are often called arthritis or spondylosis. This can also occur after prolapse of a disc fragment into the nerve root canal (cervical disc prolapse).
MRI shows disc prolapse at C6-7 level causing pressure on the right C7 nerve root.
What are the symptoms?
Cervical radiculopathy pain travels down the arm in the area of the involved nerve. Pain is usually described as sharp. There can also be a “pins and needles” sensation or even complete numbness. In addition, there may be a feeling of weakness with certain activities. Symptoms can be worsened with certain movements, like extending or straining the neck or turning the head. These symptoms are often made better by placing the hand on the head and stretching the shoulder.
What are the standard investigations?
X-rays can show the alignment of bones along the neck. They can also show any narrowing of the foramen and discs. An MRI of the neck can show if nerve compression is caused by soft tissue, such as a bulging disc and herniations (see figure). MRI can also show the appearance of the spinal cord and nerve roots.
What is the treatment?
Majority of patients with cervical radiculopathy get better with time and anti-inflammatory medications. Some patients will have the pain go away quickly over days to weeks, while others take longer. Some patients do develop persistent symptoms and require surgical treatment for the arm pain or weakness.
Nonsurgical Treatment
Treatment for radiculopathy starts with nonsurgical options.
Soft Collars: Soft collars allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.
Physical Therapy: Physical therapy exercises help with neck muscle stretching and strengthening. Sometimes, traction is also used for short periods.
Medications include nonsteroidal anti-inflammatories, oral corticosteroids and neuropathic drugs like pregabalin and gabapentin.
Surgical Treatment
There are several surgical procedures for radiculopathy. The options include the anterior cervical discectomy and fusion (with patient’s own bones – iliac autograft, bank bone – allograft) supplemented with cage and plates, or artificial disc replacement). The procedure that is right for you will depend on many factors, most importantly the type of problem you have.
What is cervical micro-discectomy and fusion?
Through a small incision on the front of the neck, the spine is accessed. Under microscope visualization the disc material compressing the nerve is removed. This relieves the pain and allows the nerve to regain its normal function.
Picture showing a standard 4 cm skin crease incision along the front of neck used for a discectomy. The disc is removed relieving pressure on the nerves.
The empty disc space is filled with bone graft to achieve fusion (joining) between the vertebrae. Occasionally the vertebrae may be fixed using a cage and a plate.
MRI shows disc prolapse at C6-7 level with proximal migration causing pressure on the right C6 and C7 nerve root. The post –operative xray shows C6 corpectomy from the front and fusion with expandable cages and plate.
Cervical disc replacement
MRI shows disc prolapse at C6-7 level causing pressure on the right C7 nerve root. The post –operative xray shows discectomy from the front and replacement with an artificial disc.
The empty disc space is filled with an artificial disc to ensure movement at the disc space. The procedure is similar to a joint replacement in the hip or knee. The diseased disc is replaced by an artificial disc. It preserves the motion between the adjacent vertebrae. As in a cervical micro-discectomy, the disc material compressing the nerve root is removed. Instead of fusing the vertebrae with bone, an artificial disc is placed in the disc space. The major advantage of this procedure is that it preserves motion and in comparison to fusion, motion preservation decreases the chances of degeneration at the disc level above and below the diseased level. Among the different surgical options available, the surgeon will assess the symptoms, radiographs and MRI scans to plan the best surgical option for the patient.
Surgical Expertise
Testimonials
What Our Patients Say
Book Your Appointment Today!
Call us at 099644 83761 to schedule your visit. Your path to recovery begins at Dr. Ankith’s Orthopedic & Spine Care Clinic. We look forward to helping you achieve your health goals!