Ask the Expert: Cervical Radiculopathy
In honor of World Spine Day, Dr. Han Jo Kim, Orthopedic Spine Surgeon, answers readers’ questions on cervical radiculopathy.
Q1. What is cervical radiculopathy?
Cervical radiculopathy is pain that radiates from the neck down to the shoulder and the arm in a dermatomal distribution that can often result in numbness or weakness (or both) in the arm or hand as well.
Q2. What is the cause of cervical radiculopathy?
It can be caused by a number of problems related to arthritis and degeneration of the cervical discs which result in shrinking the dimensions of the neuroforamen (the area where the nerve roots exit the spinal cord and go down the arm). The disc is composed of the thick annulus (fibrocartilage) and the soft nucleus pulposus (gel-like substance). As the annulus degenerates, the nucleus pulposus can herniate through tears in the annulus resulting in compression of the nerve root exiting the neuroforamen, causing cervical radiculopathy. With progressive degeneration, you can also develop bone spurs of the uncinate (part of the cervical vertebral body) that impinge on the neuroforamen and compress the nerve root. Finally, you can develop cervical radiculopathy from bone spurs that develop in the facet joints. These bone spurs can also impinge on the exiting nerve root and cause cervical radiculopathy.
Q3. What are some symptoms of cervical radiculopathy?
Usually, patients with cervical radiculopathy will have pain that radiates from the neck down the arm. The pain can also be accompanied by numbness and tingling in a dermatomal distribution that is associated with that nerve root. Occasionally, weakness can also result in the muscles of the arm, wrist and hand that correspond to the compressed nerve root.
Q4. What are common treatments for cervical radiculopathy (both surgical and non-surgical)?
Fortunately, the majority of patients with cervical radiculopathy for the first time have an improvement or a resolution of symptoms. Non-surgical methods for treatment include:
- A neck brace for a short time period (not recommended for more than 1-2 weeks)
- Physical therapy
- Cervical steroid injections
- Anti-inflammatory medications Narcotic pain medications (also only for a short time period)
Surgical methods for treatment include an anterior cervical decompression and fusion, posterior cervical foraminotomy, anterior cervical foraminotomy and cervical disc replacement.
Q5. What do you envision for the future for cervical radiculopathy?
The future of cervical radiculopathy lies in better understanding those patients who will not improve their symptoms over time so that treatment can be delivered quickly and efficaciously to return patients to being symptom-free. In addition, as technology improves, surgical methods for management may also improve to even better standards.
Dr. Han Jo Kim is an Orthopedic Surgeon at Hospital for Special Surgery, specializing in Cervical Spine and Scoliosis Surgery. As the Co-director of Research and Education for the Scoliosis Service, he is a lead investigator for numerous research studies and has won multiple awards in the national and international arena. Dr. Kim has also volunteered time as a surgeon at the FOCOS hospital in Ghana, West Africa where he has successful operated on over 50 rare and complex spinal deformities.