Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

Abstract

J Korean Neurosurg Soc 48 : [473][474][475][476][477][478][479] 2010 A cervical radiculopathy is the most common symptom of cervical degenerative disease and its natural course is generally favorable. With a precise diagnosis using appropriate tools, the majority of patients will respond well to conservative treatment. Cervical radiculopathy with persistent radicular pain after conservative treatment and progressive or profound motor weakness may require surgery. Options for surgical management are extensive. Each technique has strengths and weaknesses, so the choice will depend on the patient's clinical profile and the surgeon's judgment.

The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament

“…Although 40%-80% of patients with radicular pain respond well to conservative treatment, 8,11,12,16 persistent radicular pain after conservative treatment and progressive or profound motor weakness indicate the need for surgery. The effectiveness of posterior foraminotomy for cervical radiculopathy is reported to be 82.1%-86.4%.…”

“…The current diagnostic and treatment guidelines are usually limited to the C5-8 position 12,19 since only a few cases have been reported for the first 4 spinal nerves. 3,4,6,9,18 The published consensus is that the dermatome of the C-4 nerve is distributed through the upper part of the posterior neck and anterior chest.…”

Cervical Radiculopathy Alleviating by Manipulative Correction of Cervical Hypolordosis

“…The majority (78%) of cervical radiculopathies result from foraminal encroachment by degenerative bony changes. Disc herniation and spinal instability consist of the remainders [1]. In acute state, radicular pain comes primarily from compression and inflammation, whereas in chronic radiculopathy, pain is usually caused by fibrosis [4].…”

“…About 78% of cases result from foraminal encroachment by degenerative bony changes [1]. Conservative approach is advocated as initial modality for most patients [2].…”

Cervical Radiculopathy: Focused on Primary Care

“…The simple radiography of the cervical spine is the first study that must be performed. This allows the evaluation of the spine alignment, possible tumors, among others [12]. The extension and flexion projections allow us to determine the instability of the cervical spine when it is not appreciated on the PA and lateral projections [13].…”