Kraus Back & Neck Institute: 281.446.3876(281.44.Neuro)

Conditions

Cervical Radiculopathy

Cervical radiculopathy is pain and symptoms that spread or radiate. The problem develops when a nerve root in your neck is compressed or irritated. You may recognize this disorder by terms such as nerve root impingement, nerve entrapment, or pinched nerve. Cervical radiculopathy is more common in adults and seniors than young people.

The cervical nerve roots branch off the spinal cord and travel through passageways into your upper back, shoulders, arms, and hands. These nerves control upper body function and sensation. This means radiculopathy may affect arm coordination (function) or produce pain or numbness (sensation).

Your cervical spine begins below the base of the skull. It is made up of 7 vertebral bodies, discs, ligaments, the spinal cord, and 8 pair of spinal nerve roots.

Spinal Nerve Body Area: Function and Feeling
C1 and C2 Head
C3 and C4 Diaphragm; a muscle below your rib cage important to breathing
C5 Deltoids; shoulder muscles
C6 Biceps; upper arm flexion
Wrists; flexion and extension
C7 Triceps; muscles that straighten your elbow
C8 Hands

Where nerve compression may occur:

  • Neuroforamen are naturally created nerve pathways at the left and right sides between two vertebral bodies.
  • Left and/or right sides of the neck and upper extremities
  • Central canal refers to the area around and the spinal cord*

Different disorders can cause radiculopathy

  • Bony overgrowths called osteophytes
  • Bulging or herniated discs
  • Degenerative disc disease
  • Thickening of spinal ligaments

Symptoms

Neck pain is the foremost symptom. Radicular pain may spread (radiate) across one or both shoulders and down one or both arms. When motor function is impaired, it may be difficult to lift your arms over the head. Your arms and/or hands may feel weak. It can be difficult to coordinate hand movement or lift things. Symptoms may develop suddenly or gradually.

  • Pain, mild to severe
  • Muscle weakness
  • Sensations: burning, tingling, numbness, pins and needs
  • Headache

Accurate diagnosis

Consult an expert about your neck pain and symptoms especially, if you have a pre-existing or changing spinal disorder. An accurate diagnosis is essential to an effective and successful treatment plan.

Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, their severity, when they started, and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.

Diagnostic testing may include x-rays, CT or MRI scans, or myelography to enhance the surgeon's examination of your nerve roots and spinal cord. Other studies your doctor may perform include testing your nerves and muscles; nerve conduction study (NCS) and electromyography (EMG), respectively.

Treatment

Cervical radiculopathy can often be treated without spine surgery. Your doctor may combine two or more therapies to maximize your treatment success.

Non-surgical treatments

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Pain medication (a narcotic, painkiller)
  • Muscle relaxing medication
  • Spinal injection
  • Short-term bracing relieves some of the weight of the head off the neck
  • Physical therapy
  • Traction
  • Acupuncture

When your surgeon may discuss surgical treatment

  • Spinal instability
  • Neurologic dysfunction
  • Pain and symptoms are unrelenting

The goal of surgery is to decompress—take pressure off—the nerve roots and/or spinal cord. Decompression is a surgical procedure that involves trimming or removing whatever is causing compression. Many procedures can be performed using minimally invasive surgical techniques and instruments. Your surgeon will discuss the most appropriate procedure for you and help you understand the possible risks and benefits.

Decompressive laminectomy removes (ectomy) the lamina to create more space around spinal nerves and/or the spinal cord. The procedure is called a decompressive laminotomy when part (otomy) of the lamina is removed.

Laminoplasty expands the size of the spinal canal by lifting one side of the lamina. This procedure retains spinal stability and reduces the need for fusion.

Discectomy removes a part or the entire intervertebral disc.

Foraminotomy enlarges the size of the neuroforamen to decompress nerve roots.

Instrumentation and fusion stabilize the spine and may be combined with another procedure, such as discectomy. Instrumentation utilizes screws and plates to secure the neck. Bone graft is packed around the instrumentation to help the spine heal and fuse two or more vertebrae together.

Next steps

We hope this information about cervical radiculopathy has answered your immediate questions. Remember, your doctor is your most valuable source to answer your questions about symptoms and your healthcare.

Gary Kraus, MD,
Neurosurgeon, is Board Certified
Meet Gary Kraus, MD
Masaki Oishi, MD,
Spine Fellowship at the University
Meet Gary Kraus, MD
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