Cervical radiculopathy, or a pinched nerve, is defined as a disorder that affects a spinal nerve root in the cervical spine, causing pain to radiate down the arm. Cervical radiculopathy causes pain in the neck that radiates into the shoulders and arms. Additionally, it may also give rise to muscle weakness, pins and needles and numbness. Cervical radiculopathy is marked by nerve compression, typically from herniated disc material or arthritic bone spurs.
The spine comprises 33 bones known as vertebrae, each of which is stacked on top of another. The cervical spine consists of the seven small vertebrae that begin at the skull base and form the neck. Other parts of the spine include;
Nerve roots branch out from the spinal cord through openings in the vertebrae and transport messages between the brain and the other organs of the body.
These are the flexible discs present between the vertebrae. These are important for the spine’s normal functioning and act as shock absorbers when you walk or run.
Any condition that can cause irritation or compression to the cervical nerve root can cause cervical radiculopathy. The two most prevalent causes of cervical radiculopathy are as follows;
Cervical foraminal stenosis:
This happens when degenerative changes in the discs or vertebrae narrow the openings in your vertebrae (cervical foramina), causing them to pinch nerve roots. These degenerative changes are very common.
Cervical Herniated disc:
A herniated disc often occurs with lifting, pulling, bending, and twisting movements. When a disc is herniated, its material compresses or inflames the nerve root and causes pain.
Other less prevalent causes of cervical radiculopathy are:
The most obvious symptom of cervical radiculopathy is pain that spreads into the arm, neck, chest, upper back, and shoulders. Cervical radiculopathy symptoms occur most commonly on just one side of the body, but they can be on both sides. Some of the other symptoms may include;
Sensory issues: These are issues such as numbness or tingling in the fingers or hands.
Motor problems: Motor problems involve weakness in the muscles of the arms, hands, or shoulders.
These involve the change in the body’s involuntary reflex responses. Some examples are the decreased ability of the body when the skin touches hot or cold.
After studying the patient’s general health and medical history, the following tests are performed for diagnostic purposes;
This involves the inspection of the patient’s neck by the doctor for any abnormalities. Various tests and observations are performed to understand better the neck’s posture, range of motions, reflexes, muscle strength, and sensations felt in legs and arms.
Follow are some imaging tests done to narrow down the cause of neck pain;
X-rays use electromagnetic waves to produce images of dense structures. They can reveal the vertebral openings and the general bony structure.
MRI (Magnetic Resonance Imaging)-
These use magnetic fields to detect nerve root compression / to assess the health of the cervical discs and the spinal cord.
EMG measures the electrical impulses of the muscles at rest and during contractions. EMG studies are often performed along with nerve conduction studies to determine if the nerve is functioning properly.
Some factors that increase the risk for cervical radiculopathy are;
The non-surgical and surgical methods available for cervical radiculopathy treatment are given below;
Powerful anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen, are often prescribed to cure the pain.
Physical therapy to reduce pain
The most popular physical therapies that may be useful in treating cervical radiculopathy are gentle cervical traction, mobilization, exercises, and other modalities.
Cervical epidural steroid injection
If the nerve root is inflamed or compressed, steroids may be injected epidurally. In this process, an injection is carefully placed in the cervical spine’s epidural space to bring the medication flow to the affected nerve root and cause relief.
When symptoms of cervical radiculopathy do not go away and persist for a long time, surgery may be offered. Surgery treats cervical radiculopathy by decompressing nerves in your neck. Depending on the factors such as symptoms and the location of the involved nerve root, the following surgeries can be performed;
Anterior Cervical Diskectomy and Fusion (ACDF)
ACDF involves removing the problematic disc or bone spurs and then stabilizing the spine through spinal fusion. The main aim of ACDF is to restore the alignment of the spine and increase the space available for the nerve roots to leave the spine. It limits motion across the degenerated segment of the spine.
Cervical Artificial Disc Replacement (ADR) / Cervical Total Disc Arthroplasty (TDA)
A cervical disc replacement involves removing the degenerated disc, as in an ACDF procedure, but rather than fusing the vertebra, a disc replacement is inserted. This theoretically allows motion to continue in that vertebral segment, reducing the pressure on adjacent discs.
Dr Sherief is one of the most renowned spinal surgeons for Cervicobrachial pain treatment in Dubai. He has a great clinical success record in performing surgeries to treat patients suffering from cervical radiculopathy in Dubai. He has received multiple prestigious awards for his research and contributions to developing a system for managing spinal infections. He is also one of the very few surgeons worldwide trained in the use of robot-assisted surgeries. His patients’ reviews are the testimonials of his caring, confidential and discreet approach to them.