Cervical Radiculopathy

Cervical radiculopathy is a common cause of neck pain. Also called a pinched nerve in your neck, cervical radiculopathy can cause pain that spreads beyond your neck into your shoulders, arms or back. Over time, this pain can affect your quality of life and limit your range of motion, preventing you from working or enjoying your favorite activities. Summit Orthopedics provides advanced care for cervical radiculopathy in the greater Minneapolis/St. Paul area.

What Is Cervical Radiculopathy?

Radiculopathy is a compression or irritation of one or more spinal nerves. It is usually caused by inflammation, injury or a condition such as spinal stenosis that can create nerve compression. Radiculopathy can occur at any point along the spine from the neck to the middle back (thoracic radiculopathy) to the lower spine (lumbar radiculopathy). When this compression or “pinching” of the nerve is in the neck (cervical spine), this condition is called cervical radiculopathy. Most cases of cervical radiculopathy affect nerves around the C6 or C7 vertebrae.

Causes of Cervical Radiculopathy

Cervical radiculopathy can have several different causes, all of which can lead to nerve compression, damage or inflammation. They include:

• Acute injury
• Degenerative disc disease
• Herniated disc
• Spinal infection
• Spinal stenosis
• Spinal tumors

Age-related changes to your spine such as stenosis and degenerative disc disease are among the most common causes of cervical radiculopathy. Injury is also a common cause, especially among younger people. You may be at risk for cervical radiculopathy if you smoke or have a job that requires heavy lifting or driving.

Symptoms

There are many symptoms of a pinched nerve in the neck and shoulder, including:

• Feelings of “pins and needles” or tingling in your fingers or hand
• Neck pain that radiates out to your back, shoulders or arms
• Neck pain that worsens with certain movements
• Numbness or loss of sensation
• Weakness in your shoulder or arm

Your pain may be a dull ache, or it may be sharp and burning. Over time, increased pressure on a nerve root can cause permanent damage, including to peripheral nerves beyond the spinal cord. If your pinched nerve symptoms do not go away on their own after a few days to a week, you should contact a Summit Orthopedics specialist.

If you are experiencing symptoms of cervical radiculopathy, along with loss of coordination, poor balance or changes in bowel function, you could have a condition called cervical myelopathy. Some people may ignore this pain and assume it is a severe pinched neck, but it is a more serious condition that needs prompt treatment. Other red flags of a critical problem include fever, unexplained weight loss and pain that keeps getting worse or wakes you up at night.

Diagnosis

To diagnose cervical radiculopathy, your physician will review your health history and perform a physical examination. You may be asked to bend your neck certain ways and to move your arms to demonstrate your range of motion.

Your doctor may also recommend additional testing to ensure correct diagnosis, which may include:

• CT scan
• Electromyography, or nerve conduction tests
• MRI
• X-ray

Diagnostic imaging can often show the vertebral changes causing your cervical radiculopathy so that your provider can recommend the best treatment options.

Nonsurgical Treatment

Around 90% of people with cervical radiculopathy recover without needing surgery. While some people will recover without any treatment at all, many types of nonsurgical treatment may help alleviate pain and speed recovery. Nonsurgical treatments that may help cervical radiculopathy include:

Cervical collar to support and brace the neck

• Pain relieving medication, such as nonsteroidal anti-inflammatory drugs
  (NSAIDs)
• Steroid injections
• Physical therapy
• Self-care, including rest, exercise and use of a special cervical pillow

Many people will benefit from a combination of treatments. Physical therapy can be especially effective in restoring range of motion and strength.

Surgical Treatment for Cervical Radiculopathy

Most people will not need surgical treatment for cervical radiculopathy. However, if conservative management has not improved symptoms after six weeks, your provider may discuss surgical options to decompress the nerve. In rare cases, such as when you are experiencing severe neck or arm pain along with progressive muscle weakness, surgery may be considered sooner.

Common surgical options to relieve cervical radiculopathy include:

• Anterior cervical discectomy and fusion (ACDF): ACDF is a surgical procedure to relieve the pressure placed on nerve roots or the spinal cord by a herniated disc or bone spurs in the neck. The surgeon removes the intervertebral disc to access the compressed nerves, removes the source of the pressure, and places a bone graft between the two vertebrae. In some cases, metal plates or pins provide extra support and stability to help ensure proper fusion.
• Cervical disc replacement surgery: The surgeon removes the intervertebral disc to access the compressed nerves and removes the source of the pressure. They then place an artificial disc between vertebrae.
• Laminectomy: The goal of laminectomy is to relieve pressure on the spinal nerves that is causing your symptoms. Your surgeon will remove any bone spurs and damaged disc material. As you heal in the weeks following surgery, the muscles and ligaments of the back will fill in the space where the lamina used to be.
• Foraminotomy: A foraminotomy is another decompression surgery to reduce the pressure on your spinal nerves. The surgeon makes more room for the nerves by enlarging the opening they travel through on their way out of the spinal canal.

Summit Orthopedics specializes in minimally invasive spine surgery whenever possible. Our board-certified orthopedic surgeons have the comprehensive spine expertise you need if conservative treatment is not successful.

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