Cervical Radiculopathy Flashcards Preview

724: Medical Lectures > Cervical Radiculopathy > Flashcards

Flashcards in Cervical Radiculopathy Deck (31)
1

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

in the 1940's

2

What is the most common cause of cervical radiculopathy?

compression

3

What 2 derangements can cause compression on nerve roots?

- cervical spondylosis
- disc herniation

4

Define spondylosis

general term for nonspecific, degenerative changes of spine

5

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

Zygapophyseal and uncovertebral joints

6

Radicular symptoms tend to arise following a ____ disc herniation

lateral

7

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

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

8

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

diffusely, meaning they may span multiple myotomes and dermatomes

9

What is the mean age at diagnosis of cervical radiculopathy?

47.9

10

What is the incidence ratio of men to women?

1:1.7

11

Incidence rates are highest for which age group?

50-54 years age group

12

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

C7

70%

13

C6 root involvement was found in approximately __%

20%

14

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

C5, C8, and T1

15

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

herniated disc

spondylosis

16

Where is pain experienced?

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

17

What is a danger sign associated with cervical radiculopathy?

Lhermitte’s phenomenon

18

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

tumor or infection

19

What type of events may trigger cervical radiculopathy?

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

20

Is sensory loss common or not? Explain...

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

21

What special test screens for cervical radiculopathy?

the Spurling maneuver

22

When are neuroimaging and electrodiagnostic testing indicated for diagnosis?

When...
- localizing signs and symptoms suggest a nerve root injury
- there are there are persistent symptoms that do not resolve with conservative therapy

23

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

imaging with contrast

24

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

MRI

25

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

- Pain arising from the zygapophyseal or uncovertebral joints
- Orthopedic problems of the neck or shoulder
- Entrapment neuropathy
- Brachial plexopathy

26

What does prognosis depend upon?

Whether the cause is compressive or noncompressive

27

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

conservative

28

What are some examples on conservative therapy?

- 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

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

Epidural glucocorticoid injections

30

What are the criteria for surgery?

- 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

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

- Anterior cervical discectomy and fusion
- Posterior laminoforaminotomy
- Artificial disc replacement