4- Cervical Radiculopathy Flashcards
_______ were first recognized as a cause of radicular symptoms in the arm in the absence of myelopathy in the 1940’s.
ruptured cervical discs
What is radiculopathy?
a pathologic process affecting the nerve roots
What are some pathophysiologic causes of cervical radiculopathy? Which is more common?
- Compression (more common)
- Disc herniation
What are some causes of noncompressive radiculopathy?
- Diabetes
- Vasculitis with nerve root infarction
- Infectious or granulomatous
- Infiltration
- Acute demyelination
What does noncompressive cervical radiculopathy affect?
the ventral and dorsal roots more diffusely and may span multiple myotomes and dermatomes
What is acute cervical radiculopathy commonly caused by?
Herniated disc
What is indolent radiculopathy caused by commonly?
Spondylosis
What are some danger signs?
Lhermitte’s phenomenon
What are some typical antecedent events?
- Physical exertion
- Trauma
- MVA
What are some tests for this?
- Spurling Maneuver
- Shoulder abduction relief test
When is neuroimaging and electrodiagnostic testing indicated?
- when localizing signs and symptoms suggest a nerve root injury
- when there are persistent symptoms that do no resolve with conservative therapy
What is the study of choice for diagnosing cervical radiculopathy?
MRI
What are some differential diagnoses for cervical radiculopathy?
- pain arising from the zygoapophyseal or uncovertebral joints
- orthopedic problems of the neck or shoulder
- entrapment neuropathy
- brachial plexopathy
What is different about compressive vs. noncompressive radiculopathy?
Compressive (conservative threapy preferred, motor weakness should trigger early diagnostic workup)
Noncompressive (influenced by the natural history and response to therapy of the underlying condition)
What sort of injection can be used to help treat cervical radiculopathy? What are some complications?
Epidural glucocorticoid injections, risk of ischemic complications with particulate glucocorticoid
