What Is Cervical Radiculopathy?
Cervical radiculopathy is a condition in which one or more nerves in the neck are either irritated or compressed and do not work properly. The emphasis is on the nerve root, instead of the spinal cord (see Spine Anatomy). This condition often causes pain (radicular pain), weakness, numbness or difficulty controlling specific muscles in the arm.
The problem is at or near the root of the nerve, as it exits from the spinal canal. However, patients may experience pain and have other associated symptoms in their arms through a process called referred pain.
Nerve irritation may result from:
Signs and Symptoms
Nerve irritation may cause sensory and/or motor abnormalities. Patients often complain of neck and/or arm pain. There is tingling and numbness down the shoulder, arm, and sometimes hand and fingers. Weakness and reflex loss may be found. Some patients experience headache in the back of the head that sometimes goes to the top or behind the ears.
Dr. Cho will conduct a thorough history and physical examination during your initial visit to learn what kind of symptoms you are experiencing. A set of x-rays of the cervical spine are often helpful to assess which level(s) are involved. Additional tests like MRI, CT and nerve conduction studies may be needed.
Most patients suffering from cervical radiculopathy can be successfully treated without surgery. Some of the non-operative treatments include aerobic exercise, physical therapy, various modalities (heat/cold treatments, massage therapy, and traction among others), neck brace, as well as the use of medications, such as muscle relaxants, non-steroidal anti-inflammatory drugs, Tylenol, or a short course of steroids. Nerve root blocks or epidural steroid injection can be helpful at times.
Surgery is reserved for select group of patients who have severe pain and/or present with profound or increasing weakness or numbness. Depending on the cause of cervical radiculopathy, Dr. Cho will offer the best type of procedure that is suited for each patient. The spine can be approached from either the front (anterior) or the back (posterior) of the neck. Anterior cervical discectomy and fusion is a highly effective procedure with excellent success rate. Motion-preserving procedures such as minimally invasive posterior laminoforaminotomy or artificial disc replacement may be offered as an alternative.