Radiculopathies - week 21

Question 1

What is a radiculopathy?

Answer 1

Compression of a nerve root (sciatica)

Question 2

Epidemiology of Radiculopathies?

Answer 2

Disc degeneration from 30s
more men than women

Question 3

Risk factors of radiculopathies?

Answer 3

Aging
Being overweight
Poor posture
Bad lifting techniques
Repetitive motions
Family history of degenerative bone conditions

Question 4

Pathophys of radiculopathies?

Answer 4

Stenosis
Osteophytes
Disc herniation
Trauma

Question 5

Presentation of cervical radiculopathies?

Answer 5

Pain in neck, radiates in distribution of affected nerve root
Paraesthesia and sensory loss
Lower motor neuron signs - weakness, wasting and reflex impairment

Question 6

What muscle weakness, sensory loss and reflex loss occurs in C5 compression?

Answer 6

Muscle Weakness = Bicep, Deltoid, Spinati
Reflex Loss = Biceps
Sensory loss = lateral arm

Question 7

What muscle weakness, sensory loss and reflex loss occurs in C6 compression?

Answer 7

Muscle Weakness = Brachioradialis
Reflex Loss = Biceps, supinator
Sensory loss = lateral forearm, thumb, index finger

Question 8

What muscle weakness, sensory loss and reflex loss occurs in C7 compression?

Answer 8

Muscle Weakness = Triceps, Fingers, Wrist Extensors
Reflex Loss = Triceps
Sensory loss = Middle finger

Question 9

Presentation of lumbar radiculopathies?

Answer 9

Onset may be sudden or gradual
Constant aching pain felt in the lumbar region
Pain is exacerbated by coughing or straining. Relieved by lying flat.
Pain may radiate to the buttock, thigh, calf and foot

Question 10

What muscle weakness, sensory loss and reflex loss occurs in L4 compression?

Answer 10

Femoral nerve
Sensory Loss = Anterior Thigh
Muscle Weakness = Knee Extension
Reflex Loss = Knee
Positive Femoral Stretch Test

Question 11

What muscle weakness, sensory loss and reflex loss occurs in L5 compression?

Answer 11

Sensory Loss = Dorsum of Foot
Muscle Weakness = Ankle dorsiflexion, ankle inversion, hip flexion, foot drop, big toe dorsiflexion
Reflex Loss = None
Positive Sciatic Nerve Stretch Test

Question 12

What muscle weakness, sensory loss and reflex loss occurs in S1 compression?

Answer 12

Sensory Loss = Posterolateral aspect of leg and lateral aspect of foot
Muscle Weakness = Plantar Flexion
Reflex Loss = Ankle Reflex
Positive Sciatic Nerve Stretch Test

Question 13

investigations for radiculopathies?

Answer 13

No imaging if no trauma
MRI is trauma
EMG and nerve conduction studies

Question 14

Management of radiculopathies?

Answer 14

NSAIDS/Corticosteroids (these in injection form too)
Physio
surgery

Question 15

Prognosis of radiculopathies?

Answer 15

> 90% improve by 4 weeks