The Insight to Cervical Radiculopathy
By Neurosurgery Singapore
Cervical radiculopathy, often called a pinched nerve, is the damage or a change in the way a nerve works resulting from one of the nerve roots near the cervical vertebrae being compressed. These seven small vertebrae form your cervical spine, or neck, and begin at the base of your skull. This the area in which cervical radiculopathy occurs.
The nerves that run through your cervical spine send messages back forth between your muscles and your brain. The roots of these nerves branch out through openings in your vertebrae called foramen. Damage to these nerve roots can cause pain and the loss of sensation along the nerve’s pathway into the arm and hand, depending on where the damaged roots are located.
What are some symptoms related to Cervical Radiculopathy?
Depending on the nerve root involved, signs of cervical radiculopathy differ and usually occur on the same side of the body as the affected nerve. Symptoms can include the following:
Neck, shoulder blade, shoulder, upper chest, or arm pain, with pain that may radiate through the fingers following the nerve root route involved.
Pain in the cervical region is described as “sharp” or “pins-and-needles” or “popping sensation”.
A general dull ache or numbness somewhere along the nerve pathway.
Shoulder, arm, or hand weakness.
Pain that deteriorates with some motions of the neck.
Pain which increases when the arm is raised over the head.
“The most common causes of cervical radiculopathy are when a nerve root becomes inflamed or damaged due to a nearby bone spur or cervical herniated disc, such as from spinal degeneration over time or an injury.”
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What types of treatments?
To make a diagnosis of cervical radiculopathy, our Specialist will first ask you to describe all your symptoms and review your medical history. They will also do a physical exam.
The exam will include a check of your neck, shoulders, arms, and hands for muscle weakness and problems with sensation or reflexes. Our doctor may ask you to move your arms or neck to see if certain movements cause or ease pain or other symptoms.
They may also do these tests:
- X-rays, to look for narrowing of vertebral openings or disk injury
- CT scans, to get more detailed pictures of your cervical spine
- MRI, to check for damage to nerve roots or soft tissues
- Electromyography, to see how your muscles work when they are at rest and contracted
Possible treatments for Cervical Radiculopathy
The majority of patients with cervical radiculopathy can often be treated conservatively. Conservative treatment options include anti-inflammatory and pain medications, muscle relaxants, spinal injections, physical therapy, braces to support the spine, traction, and acupuncture. Our Specialist may recommend combining two or more treatment modalities, in order to increase your chances of successful treatment.
Surgery is usually recommended for patients with persistent pain, spinal instability or neurological dysfunction. There are several surgical procedures for cervical radiculopathy, performed using minimally invasive techniques. Surgery involves removing parts of bone or soft tissue causing the compression. The aim of the surgery is to decompress nerves and relieve the pressure. Surgical techniques that may be used include:
- A decompressive laminectomy: It is a surgical procedure in which a portion of the bone or lamina responsible for the compression is removed.
- Laminoplasty: It is a surgical procedure to expand the size of the spinal canal and release the pressure over the spinal cord and nerve roots.
- Discectomy: It is a surgical procedure for the removal of a herniated or ruptured disc from the affected region.
- Foraminotomy: It is a surgical procedure for widening the neuroforamen, to relieve the pressure over the compressed nerves.
- Instrumentation and fusion: Spinal Fusion is a surgical technique in which two or more vertebrae are joined with the help of bone grafts and/or instrumentation. Spinal instrumentation is a method of stabilizing the spine with the help of implants such as rods, plates, screws, and interbody devices.
Our Neurosurgeon will discuss surgical options and the associated risks and benefits as well as recommend the most appropriate procedure for you.