Dr Prashanth Rao MBBS, MS, DNB, MRCS, FRACS, PhD Adult & Paediatric Neurosurgeon and Spine Surgeon Ph: 02 9052 7567 Fax: 02 8322 1889 Website: BrainandSpineSurgery.com.au

Cervical Radiculopathy

Cervical radiculopathy is pain going down the arm or shoulder is commonly caused by a “pinched” nerve. It is caused by pressure on the nerve root by a disc prolapse or a combination of disc and bone spur(‘osteophyte’). As we grow older, the spinal discs become dehydrated, lose height and the disc bulges. Vertebrae come closer and the disc collapses form bone spurs in order to stiffen the spine. Due to this process the bony canal for the nerve(foramen) narrows and compresses the nerve. This aging process is called spondylosis and is degenerative in nature.

The pain caused by this condition is sharp and may be accompanied by pins and needle type of sensations. Sometimes patients may even feel weak. It may worsen with extending the neck or turning the head.

Diagnosis

The diagnostic tests Dr Rao commonly uses are MRI scan, CT scan, X -rays, SPECT/Bone scan and occasionally Nerve conduction/electromyography tests. But each patient’s presentation differs and hence tests ordered may vary

Treatment

Often, cervical radiculopathy is initially treated by nonsurgical treatment methods such as physiotherapy, pain medications, modification of workplace etc. If the symptoms are severe steroidal (cortisone)injections may be trialled . If the conservative treatments fail or if the condition is severe or there are neurological deficits(weakness) Dr Rao may advice surgical treatment. Goals of surgery include creation of more space for the nerves, to restore the anatomy of the spine and stabilize the spine. In some patients restoring the motion of the spine with artificial disc may be advised. The three types of procedures that can be done usually for cervical radiculopathy include;

1. Anterior Cervical Discectomy and Fusion

https://www.spine.org/KnowYourBack/Treatments/SurgicalOptions/AnteriorCervicalFusion 2. Posterior Cervical Foraminotomy

https://www.spine.org/KnowYourBack/Treatments/SurgicalOptions/PosteriorCervicalForaminotomy

3. Anterior Cervical Disc replacement https://www.spine.org/KnowYourBack/Treatments/SurgicalOptions/CervicalDiscReplacement