EC Orthopaedics

Review Article Volume 13 Issue 12 - 2022

Evaluation and Management of Cervical Radiculopathy from Disc Herniation and Degenerative Disorders

Selvaraj Periyasamy1*, Prem James Charles2 and Ashwin Narasimhaprasad3

1Specialist Orthopedic Surgeon and Medical Director, RALS Clinic, Dubai, UAE
2Specialist Orthopedic Surgeon and HOD Emergency Department, Adam Vital Hospital, Dubai, UAE
3Specialist Orthopedic Surgeon, Aster Clinic, Dubai, UAE
*Corresponding Author: Selvaraj Periyasamy, Specialist Orthopedic Surgeon and Medical Director, RALS Clinic, Dubai, UAE.
Received: November 29, 2022; Published: December 08, 2022



Cervical radiculopathy (CR) is the disturbance of cervical spinal nerve roots giving rise to significant pain and functional impairment. While degenerative spinal diseases are the most common cause of CR, especially in the older age groups, herniation of the cervical discs is the most common cause in the younger population.

The primary symptom of CR is neck pain that radiates down to the shoulders, arms, forearm, and hands up to the fingers. Pain is often associated with sensory and/or motor symptoms depending upon the stage and severity of the impingement of the nerve root(s). The symptoms may start as acute from a single event or as chronic from repeated episodes.

Most cases of CR are managed by conservative measures which include anti-inflammatory medications, cervical collars, physical therapy, and exercises. Surgical interventions are rarely necessary and are reserved for those cases with significant neurological deficits.

In this article, we discuss key points in the clinical evaluation and methods of conservative management of the two major causes of cervical radiculopathy, i.e. cervical degenerative disorders and cervical disc herniation.

 

Keywords: Neck Pain; Cervical Radiculopathy; Disc Herniation; Spondylosis

  1. North American Spine Society. “Evidence-based clinical guidelines for multidisciplinary spine care. Diagnosis and treatment of cervical radiculopathy from degenerative disease” (2010).
  2. Radhakrishnan K., et al. “Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990”. Brain2 (1994): 325-335.
  3. Hilibrand AS., et al. “Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis”. Journal of Bone and Joint Surgery 4 (1999): 519-528.
  4. Green BN. “A literature review of neck pain associated with computer use: public health implications”. Journal of the Canadian Chiropractic Association 3 (2008): 161-167.
  5. Carroll LJ., et al. “Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders”. Journal of Manipulative and Physiological Therapeutics 2 (2009): S87-S96.
  6. M Mansfield., et al. “Cervical spine radiculopathy epidemiology: a systematic review”. Musculoskeletal Care 4 (2020): 555-567.
  7. Roh JS., et al. “Degenerative disorders of the lumbar and cervical spine”. Orthopedic Clinics of North America 3 (2005): 255-262.
  8. Kuijper B., et al. “Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review”. European Journal of Neurology 1 (2009): 15-20.
  9. Henderson CM., et al. “Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases”. Neurosurgery5 (1983): 504-512.
  10. Tong HC., et al. “The Spurling test and cervical radiculopathy”. Spine 2 (2002): 156-159.
  11. Rubinstein S., et al. “A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy”. European Spine Journal 3 (2007): 307-319.
  12. Kleinrensink G., et al. “Upper limb tension tests as tools in the diagnosis of nerve and plexus lesions: anatomical and biomechanical aspects”. Clinical Biomechanics 1 (2000): 9-14.
  13. Roth D., et al. “Cervical radiculopathy”. Disease-a-Month 12 (2009): 737-756.
  14. Teresi LM., et al. “Asymptomatic degenerative disk disease and spondylosis of the cervical spine: MR imaging”. Radiology1 (1987): 83-88.
  15. Gilbert JW., et al. “Open stand-up MRI: a new instrument for positional neuroimaging”. Journal of Spinal Disorders and Techniques 2 (2006): 151-154.
  16. Houser OW., et al. “Cervical spondylotic stenosis and myelopathy: evaluation with computed tomographic myelography”. Mayo Clinic Proceedings 6 (1994): 557-563.
  17. Alrawi M., et al. “The value of neurophysiological and imaging studies in predicting outcomes in the surgical treatment of cervical radiculopathy”. European Spine Journal 4 (2007): 495-500.
  18. Pedersen LM., et al. “Serum levels of the pro-inflammatory interleukins 6 (IL-6) and-8 (IL-8) in patients with lumbar radicular pain due to disc herniation: A 12-month prospective study”. Brain, Behavior, and Immunity 46 (2015): 132-136.
  19. Guan Q., et al. “Cervical intradural disc herniation: A systematic review”. Journal of Clinical Neuroscience 48 (2018): 1-6.
  20. Wong JJ., et al. “The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature”. Spine Journal 8 (2014): 1781-1789.
  21. Dworkin R., et al. “Pharmacologic management of neuropathic pain: evidence-based recommendations”. Pain 3 (2007): 237-251.
  22. Iyer S and Kim HJ. “Cervical radiculopathy”. Current Reviews in Musculoskeletal Medicine 3 (2016): 272-280.
  23. Levine MJ., et al. “Cervical radiculopathy: diagnosis and nonoperative management”. Journal of the American Academy of Orthopaedic Surgeons 6 (1996): 305-316.
  24. Caridi JM., et al. “Cervical radiculopathy: a review”. HSS Journal 3 (2011): 265-272.
  25. A Jellad., et al. “The value of intermittent cervical traction in recent cervical radiculopathy”. Annals of Physical and Rehabilitation Medicine9 (2009): 638-652.
  26. Arianne P Verhagen. “Physiotherapy management of neck pain”. Journal of Physiotherapy1 (2021): 5-11.
  27. Cassidy JD., et al. “Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study”. Spine4 (2008): S176-S183.
  28. Beer A., et al. “Can a functional postural exercise improve performance in the craniocervical flexion test?-a preliminary study”. Manual Therapy 3 (2012): 219-224.
  29. Saal JS., et al. “Nonoperative management of herniated cervical intervertebral disc with radiculopathy”. Spine16 (1996): 1877-1883.
  30. O’Leary S., et al. “Muscle dysfunction in cervical spine pain: implications for assessment and management”. Journal of Orthopaedic and Sports Physical Therapy 5 (2009): 324-333.
  31. Lees F and Turner JW. “Natural history and prognosis of cervical spondylosis”. British Medical Journal 5373 (1963): 1607-1610.
  32. Nordin M., et al. “Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders”. Spine 4 (2008): S101-S122.

Selvaraj Periyasamy., et al. “Evaluation and Management of Cervical Radiculopathy from Disc Herniation and Degenerative Disorders”. EC Orthopaedics 13.12 (2022): 18-27.

ECronicon Journal

Our Services

Quick Links

Information

Creative Commons LicenseOpen Access by ECronicon is licensed under a Creative Commons Attribution 4.0 International License
Based on a work at www.ecronicon.net