Spine surgeons call it cervical radiculopathy. You just call it pain, numbness, and weakness. If you or someone you know has received the diagnosis of cervical radiculopathy, chances are your first thought was “what is cervical radiculopathy?” In this article we will describe cervical radiculopathy and explain how the condition causes symptoms.
What is cervical?
No medical term is too complex once you break it down. Cervical refers to the top section of your spine. The cervical spine includes seven vertebral bones along with intervertebral discs, nerve roots, and nerves. These vertebral bones are stacked on top of one another, each of them separated by an intervertebral disc. The vertebral bones can move relatively freely, which allows your neck the flexibility to move the way it does. There are also spaces in between these vertebral bones that allow nerves to exit the spinal column and extend out to the chest and arms. The place where the nerve first leaves the spinal cord is called the nerve root.
What is radiculopathy?
Anyone who has taken Latin usually has an advantage when it comes to medical terminology and anatomy. The Latin term for nerve root is radix nervi. Any medical term with the suffix “–opathy” simply means disease or disorder. Therefore, radiculopathy refers to disease or disorder of the nerve root.
What causes cervical radiculopathy?
Cervical radiculopathy is not a single disease, but rather it may have several different causes. In some cases, the intervertebral disc pushes out beyond its normal place within the spinal column. This condition is called cervical disc herniation. As the intervertebral disc extends beyond its normal boundaries, you can press against a nerve root, which causes symptoms.
The nerve root can become impinged in other ways too. In cervical foraminal stenosis, the space that allows nerve roots to exit the spinal column is simply too small or has become abnormally narrow. This also presses on the nerve root, causing symptoms.
Other conditions such as herpes zoster, Lyme disease, and diabetes can cause dysfunction in the nerve roots. The most common cause of cervical radiculopathy by far, is degenerative changes of the spine. These degenerative changes lead to bony outgrowths (i.e. bone spurs) that press out from the vertebral bone and against the nerve root. As with every cause of cervical radiculopathy, an impinged nerve root leads to dysfunction and symptoms for the patient.
What are the symptoms of cervical radiculopathy?
Once you understand the anatomy of the cervical spine, is fairly easy to understand why cervical radiculopathy causes the symptoms that it does. The nerve root carries two main types of information; it sends signals from the brain telling the body to move and it receives signals from the body about sensations. If the nerve root is impinged, these signals cannot pass normally and the nerves become dysfunctional. Thus, the body-moving signals are blocked, which leads to muscle weakness. Likewise, the sensory-receiving signals are blocked, which leads to numbness and tingling.
Since the anatomy of the cervical spine is abnormal in cervical radiculopathy, it tends to develop abnormal blood vessels and sensory nerve endings. In fact, herniated discs and other inflammation associated with cervical radiculopathy is associated with an increased number of sensory nerve endings in the spine. As you can imagine, a large number of abnormally functioning sensory nerve endings in the spine causes pain.
Treatment for cervical radiculopathy
There is no single treatment for cervical radiculopathy. People with mild or moderate cases are usually treated with conservative therapy such as oral pain medications, short course of steroids, selective rest, and physical therapy. In severe or rapidly progressing cases, cervical spine surgery is often the best first treatment. The standard surgical treatment for cervical radiculopathy is spinal fusion surgery, in which two vertebral bones are fused together. When possible, an anterior cervical discectomy and fusion is the best approach. When anterior cervical discectomy and fusion is not possible, it posterior laminoforaminotomy is used.
The best first course of action, however, is to speak with a board-certified spine surgeon. He or she will evaluate your symptoms, order the appropriate studies and tests, and devise a treatment regimen that meets your needs and fits with your priorities.
If you are having symptoms of cervical radiculopathy, contact Dr. Rovner at Progressive Spine for a consultation today.