Cervical Radiculopathy

Cervical radiculopathy is the irritation of the cervical nerve roots that can lead to symptoms into the arm. Those symptoms can be in the form of a shooting pain, numbness, weakness or a combination. It is sometimes referred to as a "pinched nerve."

Causes

Cervical radiculopathy can occur because of normal wear-and-tear we experience as we age, like arthritis. It can also be caused by a disc herniation. And in younger patients, a sudden injury can cause cervical radiculopathy.

Symptoms

Symptoms for cervical radiculopathy include shooting pain, numbness, weakness or a combination of those symptoms. The pain from cervical radiculopathy typically starts in the neck and radiates down the arm.

Diagnosis

The diagnosis of cervical radiculopathy is made by taking a good medical history, a physical exam, and cervical spine imaging such as x-rays and an MRI. On imaging, you may see a nerve being compressed by a cervical disc herniation.

Treatment

Nonsurgical Treatment

There are different ways of treating cervical radiculopathy conservatively without surgery. Most patients with cervical radiculopathy get better over time and do not need surgical treatment. Sometimes the pain from cervical radiculopathy improves but then returns. When this happens, the pain usually goes away on its own again.

Nonsurgical treatment options include:

• Physical therapy to strengthen and stretch the cervical spine
• Medications such as anti-inflammatories (NSAIDs)
• Injections to target the inflammation surrounding the nerve to help lessen the irritation and thus the pain

Surgical Treatment

If surgery is required, there are different ways of approaching cervical radiculopathy.

Anterior Approach
One surgical technique is from an anterior approach, meaning from the front. This surgical technique is designed to relieve pressure on the compressed nerves. With an anterior approach, you are removing the disc or osteophytes (bone spurs) completely. This technique requires that the disc being removed is replaced with a spacer to induce a fusion, or the growing together of bones.

Posterior Approach
The posterior approach to relieving cervical radiculopathy is designed to create space for the nerves. The reason for the pain is that the nerve is being pinched either from a disc or from extra bone that is formed from arthritis. The posterior approach is design to create space, called a laminotomy, creating space for the nerve. It often does not require a fusion.