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724: Medical Lectures > Cervical Radiculopathy > Flashcards

Cervical Radiculopathy Flashcards

1
Q

When were ruptured cervical discs first recognized as a cause of radicular symptoms in the arm in the absence of myelopathy?

A

in the 1940’s

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2
Q

What is the most common cause of cervical radiculopathy?

A

compression

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3
Q

What 2 derangements can cause compression on nerve roots?

A
  • cervical spondylosis

- disc herniation

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4
Q

Define spondylosis

A

general term for nonspecific, degenerative changes of spine

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5
Q

Bony growths at which joints typically result in the neural foramina narrowing, causing compression of the nerve roots and radicular symptoms?

A

Zygapophyseal and uncovertebral joints

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6
Q

Radicular symptoms tend to arise following a ____ disc herniation

A

lateral

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7
Q

What are some examples of diseases/disorders that can cause noncompressive radiculopathy?

A
  • diabetes
  • vasculitis with nerve root infarction
  • infections (herpes, Lyme disease, TB, syphilis, etc.)
  • infiltration
  • acute demyelination (GB)
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8
Q

Noncompressive causes of radiculopathy affect the ventral and dorsal roots more _____.

A

diffusely, meaning they may span multiple myotomes and dermatomes

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9
Q

What is the mean age at diagnosis of cervical radiculopathy?

A

47.9

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10
Q

What is the incidence ratio of men to women?

A

1:1.7

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11
Q

Incidence rates are highest for which age group?

A

50-54 years age group

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12
Q

What is the most frequently affected nerve root? It accounts for what percentage of patients?

A

C7

70%

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13
Q

C6 root involvement was found in approximately __%

A

20%

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14
Q

Involvement of which nerve roots accounted for the remaining 10%?

A

C5, C8, and T1

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15
Q

Typically if symptom onset is acute what is the cause? If onset is indolent?

A

herniated disc

spondylosis

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16
Q

Where is pain experienced?

A

In the neck, arm, shoulder, interscapular region, chest, breast, and face

17
Q

What is a danger sign associated with cervical radiculopathy?

A

Lhermitte’s phenomenon

18
Q

If there is associated fever, chills, and/or unexplained weight loss what might the cause be?

A

tumor or infection

19
Q

What type of events may trigger cervical radiculopathy?

A
  • Physical exertion in the form of golf, shoveling snow, diving from a board, etc.
  • Trauma
  • Motor vehicle accident
20
Q

Is sensory loss common or not? Explain…

A

It is frequently mild or absent due to an extensive overlap of dermatomes

21
Q

What special test screens for cervical radiculopathy?

A

the Spurling maneuver

22
Q

When are neuroimaging and electrodiagnostic testing indicated for diagnosis?

A

When…

  • localizing signs and symptoms suggest a nerve root injury
  • there are there are persistent symptoms that do not resolve with conservative therapy
23
Q

If a noncompressive radiculopathy is suspected, what type of imaging should be performed?

A

imaging with contrast

24
Q

What is the imaging study of choice for diagnosing cervical radiculopathy?

A

MRI

25
Q

What are 4 other possible diagnoses that must be ruled out first?

A
  • Pain arising from the zygapophyseal or uncovertebral joints
  • Orthopedic problems of the neck or shoulder
  • Entrapment neuropathy
  • Brachial plexopathy
26
Q

What does prognosis depend upon?

A

Whether the cause is compressive or noncompressive

27
Q

What type of therapy is preferred when compressive radiculopathy is suspected?

A

conservative

28
Q

What are some examples on conservative therapy?

A
  • Oral analgesics
  • A short course of oral corticosteroids
  • Avoidance of provocative activities
  • Cervical traction
  • Short-term neck immobilization with the use of a hard or soft cervical collar
  • Use of a cervical pillow
  • Physical therapy with exercise and gradual mobilization
29
Q

What may patients with persistent cervical radicular pain, with or without radiculopathy (inspite of conservative therapy) benefit from?

A

Epidural glucocorticoid injections

30
Q

What are the criteria for surgery?

A
  • Symptoms and signs of cervical radiculopathy
  • Evidence of cervical nerve root compression by MRI or CT myelography
  • persistence of radicular pain despite nonsurgical therapy for at least six to 12 weeks or progressive motor weakness that impairs function
31
Q

What are 3 types of surgeries that cervical radiculopathy patients may benefit from?

A
  • Anterior cervical discectomy and fusion
  • Posterior laminoforaminotomy
  • Artificial disc replacement

724: Medical Lectures (42 decks)

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