Cervical radiculopathy, known as a “pinched nerve,” occurs when a cervical nerve in your neck is compressed, damaged, irritated or inflamed at the nerve root where it branches away from the spinal cord. This may cause pain that radiates into your shoulder and/or arm and hand, as well as muscle weakness and numbness. Symptoms can vary based upon which nerve is affected. The pinched nerve can occur at different areas along the spine, such as the cervical, thoracic or lumbar areas.
Cervical radiculopathy is caused by any condition which compresses or irritates the cervical nerve. The most common causes of cervical radiculopathy are when a nerve root becomes inflamed or damaged. It is more likely to occur in older or middle-aged people due to spinal degeneration over time, and these degenerative changes can cause pressure on nerve roots. When cervical radiculopathy occurs in younger people, who are in their 20s or 30s, it is more likely due to injury or strenuous activity that has compressed or inflamed the nerve root.
Other common causes include:
Less common causes include:
Some factors which may increase your risk for developing cervical radiculopathy include:
Cervical radiculopathy involves one or more of the following neurological deficits that you may experience in the neck, shoulder, arm, hand and/or fingers:
In addition to these neurological deficits, pain is also present in most cases. These signs and symptoms may be felt in one area only, such as the neck or shoulder, or they could progress along the entire arm and into the hand, wrist and fingers.
In rare cases, despite treatments, the progression of numbness and/or weakness resulting from cervical radiculopathy may worsen. The longer numbness and/or weakness lasts in your shoulder, arm or hand, the more likely these deficits will become permanent or lead to paralysis. When nonsurgical treatments fail to adequately manage the symptoms and nerve compression has been confirmed, surgery may need to be considered in order to decompress the nerve.
The spine specialists affiliated with Memorial Hermann Mischer Neurosciences utilize a variety of advanced, state-of-the-art equipment to diagnose, locate the precise cervical area where the neurologic compression originates and detect the underlying causing conditions of cervical radiculopathy. Diagnostic tests may include:
The list of the variety of treatment options available to successfully treat this condition in most patients without surgery includes:
For those patients who continue to experience significant pain, weakness and other symptoms after exhausting other treatment options, the following surgical interventions may be recommended.
When a herniated or degenerative disc is the cause of cervical radiculopathy, our renowned team of surgeons may perform ACDF. During which time, the offending disc is removed through the front of the neck and the spine is stabilized by fusion. For patients who continue to experience significant pain, weakness and other symptoms and those of whom have exhausted other treatment options, this anterior approach has resulted in less perioperative pain—as it is one of the most common surgical treatments for cervical radiculopathy. This treatment also provides the surgeon with better access to the spine, wherein the disc can be removed without disturbing the spinal cord and nerves.
Once the disc has been removed, the surgeon then fills the open disc space with a bone graft, which serves as a bridge to stabilize the vertebrae, so that the two fuse together over the next several months to form a solid bone.
Posterior cervical laminoforaminotomy (PCL) is a surgical procedure that can be effectively used to treat the pain caused by cervical radiculopathy, which occurs from herniated discs or bone spurs. Unlike ACDF, spinal fusion is not required; therefore, typically recovery is quicker. It may be performed by minimally invasive techniques or by open surgery, depending upon the severity of pressure on the nerves.
During a PCL, the surgeon makes an incision in the back (posterior) of the neck and shaves a small amount of bone from the lamina, the part of the spine that forms the arch on the back of the spinal canal. Such an incision provides better access to the damaged nerve, so the surgeon can then remove the bone spurs and/or portion of the disc that is pressing on the nerve root.
Artificial disc replacement is a surgical technique allowing an incision to be made in the front (anterior) of the neck to remove the offending disc and replace it with an artificial version. This method helps to restore space between the vertebrae by relieving pressure on the nerve root by creating stability in the spine. The artificial disc is custom-fitted and made of metal and plastic, which helps to restore and maintain flexibility and range of motion in the spine.
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