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Cervical Radiculopathy

Article
Brain & Nerve
Bone, Muscle, & Joint
+2
Contributed byNirav Patel, DO+1 moreDec 05, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Cervical Root Lesion
  • Cervical Spondylosis with Root Compression
  • Pinched Nerve

What is Cervical Radiculopathy? (Definition/Background Information)

  • Cervical Radiculopathy is a clinical term to describe the condition that results from an abnormal pressure to the nerves within the cervical portion of the spine (i.e., in the neck)
  • It can be caused by a variety of conditions, such as a herniated disc, spinal stenosis, formation of bone spurs (osteophytes), or additional degenerative conditions
  • Individuals may experience associated symptoms in the neck, shoulders, arms, hands, and fingers

Who gets Cervical Radiculopathy? (Age and Sex Distribution)

  • Cervical Radiculopathy may occur in individuals of all age, race, ethnic groups, and gender
  • Men have a slightly higher prevalence of the disorder when compared to women
  • Various studies presented have indicated that an advanced age is one of most noteworthy risk factor associated with the condition
  • After advancing age, athletes, Caucasians, senior military personnel, army and air force service members also seem to have an increased risk for Cervical Radiculopathy in varying degrees

What are the Risk Factors for Cervical Radiculopathy? (Predisposing Factors)

Common risk factors associated with Cervical Radiculopathy include:

  • Advancing age (elderly adults have a higher risk)
  • Participation in rough or high-impact sports
  • Traumatic injury to the spine caused by automobile accidents
  • Abnormal inflammation and damage of the cartilage that line the joints such as due to osteoarthritis
  • Degenerative joint disease such as due to osteoporosis
  • Postmenopausal women
  • Inactive older individuals
  • Certain occupations that require excessive lifting of heavy objects
  • Excess body weight associated with obesity, which can abnormally increase pressure on the joints
  • Smoking
  • Poor posture

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cervical Radiculopathy? (Etiology)

Some of the causes of Cervical Radiculopathy include:

  • Degeneration of the cervical disc, which causes the space between the vertebrae to narrow (cervical spondylosis)
  • Past traumatic spinal injuries
  • Abnormal growths on the spine such as a tumor

What are the Signs and Symptoms of Cervical Radiculopathy?

Signs and symptoms associated with Cervical Spondylosis may include:

  • Excessive pain and stiffness in the neck
  • Persistent headaches
  • Numbness in the arms and legs
  • Feeling of weakness in the arms
  • Decreased range of motion in the neck
  • Tingling sensation in the arms, hands, and fingers

How is Cervical Radiculopathy Diagnosed?

Diagnostic methods that a physician may use to help diagnose Cervical Radiculopathy include:

  • Physical examination: The physician will perform a thorough physician examination. In addition to this, a complete medical history shall be evaluated
  • X-rays: X-rays are useful in visualizing the alignment of bones within the neck. They show if the intervertebral disc space has narrowed
  • Computerized tomography (CT): A CT scan takes a series of X-ray images from several different angles, which are then merged to create cross-sectional images of bones and soft tissues with the body. This allows a physician to examine the spinal column and its surrounding structures, in order to identify if any bone spurs are present close to the intervertebral disc space
  • Magnetic resonance imaging (MRI) scan: An MRI scan is a more detailed procedure that uses radio waves and a magnetic field that generates thorough images of interior bones and soft tissues. An MRI can usually identify if the spinal cord nerves are compressed due to a herniated or bulged disc
  • Electromyography (EMG): An EMG shows the electrical activity of a muscle during rest and when they contract. Examining the electrical activities may help a physician observe any nerve damage caused by certain disorders, such as diabetes. This along with other diagnostic tests, may provide very useful information about the condition
  • Nerve conduction velocity (NCV) studies: NCV shows the speed at which electrical signals move through a nerve. Slow nerve signal speed may indicate nerve damage

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cervical Radiculopathy?

Complications associated with Cervical Radiculopathy include:

  • Chronic pain in the neck
  • Prolonged weakness in the arm and hand
  • Long-lasting numbness or tingling sensation in the arm or hand
  • Loss of bladder/bowel function

How is Cervical Radiculopathy Treated?

It is important to note that the symptoms in a high percentage of individuals with Cervical Radiculopathy, resolve without any treatment (conservative or surgical methods).

The treatment associated with Cervical Radiculopathy typically begins with conservation methods. These include:

  • Wearing a specialized neck brace or cervical collar can help rest the neck muscles, while decreasing the range of motion. This aids by reducing the irritation caused to the nerves in the neck
  • Non-steroidal anti-inflammatory oral medications, such as aspirin and ibuprofen, may be used to treat Cervical Radiculopathy. These medications can help decrease the pain and swelling
  • Oral corticosteroids medications are also helpful in decreasing the pain and swelling
  • Physical therapy exercises to strengthen and improve flexibility of the neck, which may help reduce the discomfort
  • Narcotics are another type of medications that are used to relieve pain. However, these are prescribed, only in case of excessive pain and for a limited time period
  • Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged use of steroid injections increases risk of osteoporosis (i.e., weakening of the bones). Steroids may temporarily increase glucose and blood pressure levels

Surgical treatment for Cervical Radiculopathy may be recommended, if an individual does not respond to conservative management of the condition. Individuals are advised to discuss the alternatives with their physicians, before making a decision.

Surgical procedures to decrease compression of the spinal cord include:

  • Cervical laminectomy: This procedure is performed to relieve pressure on the spinal cord and/or the nerves that surround the cervical region (neck) of the body. The lamina bone of the vertebra forms the bony roof of the spinal canal, in the cervical region. During a cervical laminectomy, an incision is made in the neck and the tissue causing pressure on the nerves is removed. This helps creates more space within the spinal canal
  • Cervical laminoplasty: Cervical laminoplasty is another procedure performed to relieve pressure on the spinal cord and/or nerves located at the cervical region. During the procedure, an incision is made in the middle part of the neck and tissue, which is causing pressure on the nerves, and is manipulated to widen the spinal canal
  • Microcervical disectomy (MCD): MCD is an advanced surgical procedure used to treat individuals with cervical disc herniation. It is minimally invasive and uses a specialized surgical instrument with an attached microscope, to see the area of operation. During the procedure, the part of herniated disc that is damaged is removed, in order to relieve pressure on the spinal cord and/or nerves
  • Cervical foraminotomy: Cervical foraminotomy is performed to relieve pressure on the spinal cord and/or nerves. During this procedure, an incision is made on the back of the neck (near the region around the problem nerves), and pressure relieved by widening the opening (where nerves exit the spine), by separating the soft tissues. A cervical foraminotomy is also used to treat an unstable spine or a prolapsed disc, by removing the prolapsed disc to enhance stability

How can Cervical Radiculopathy be Prevented?

Cervical Radiculopathy is a slow progressive condition that is extremely difficult to prevent due to the risk factors increasing with an advancing age. However, following certain guidelines may help prevent an accidental injury or slow progression of the disorder. These include:

  • If you have been previously diagnosed with an injury to the nerves of the spine, avoid participating in any rough or high-impact sports
  • Begin any new physical activity slowly, with a thorough stretching regimen and complete warm-up
  • Maintain correct posture while standing, sitting, or working at a desk (or on the computer). This can help avoid unwanted pressure on the spine
  • Maintain a healthy body weight, which can help to reduce unwanted stress on the spine
  • Individuals who maintain a healthy lifestyle may decrease the likelihood of developing Cervical Radiculopathy, or at least slow down the progression of the condition

What is the Prognosis of Cervical Radiculopathy? (Outcomes/Resolutions)

  • The prognosis of Cervical Radiculopathy is usually favorable with both conservative and surgical methods of treatment
  • A high percentage of individuals with adequate treatment, typically make a full recovery with no long-term complications being noted

Additional and Relevant Useful Information for Cervical Radiculopathy:

The term radiculopathy indicates that a nerve(s) is affected at the nerve roots (where it attaches to the spine), due to factors, such as compression/irritation, resulting in impaired functionality, pain, and numbness. The most common regions where a radiculopathy occurs are the lumbar (lower back) and cervical (neck) region.

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Nirav Patel, DO picture
Reviewed by

Nirav Patel, DO

Associate Medical Director, Medical Editorial Board

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