Cervical Radiculopathy

Question 1

What is the difference of cervical radiculopathy and myelopathy?

Answer 1

Radiculopathy- nerve root compression; unilateral symptoms; larger role for non-op
Myelopathy- spinal cord compression; bilateral symptoms

Question 2

In cervical radiculopathy, which nerve root is affected by compression or irritation?

Answer 2

The lower (in C6/C7, the C7 nerve root is affected)

Question 3

What are the exam findings for C5-C8 radiculopathy?

Answer 3

C5- deltoid/biceps weakness, diminished biceps reflex
C6- brachioradialis/wrist extensor weakness; diminished brachioradialis reflex; thumb numbness
C7- triceps and wrist flexion weakness, diminished triceps reflex; numbness index and ring finger
C8- finger flexion weakness; nubmness little finger

Question 4

What movement can relieve pain in cervical radiculopathy and in an important exam finding?

Answer 4

Shoulder abduction

Question 5

What percentage of cervical radiculopathy patients improve with non-operative management?

Answer 5

75%
NSAIDs, neurontin, steroids, narcotics, muscle relaxants
Steroid injections can help

Question 6

What is the mainstay of treatment for cervical radiculopathy?

Answer 6

ACDF; single level fusion athletes can return to play

Posterior formainectomy can also be used

Question 7

What is a common complication with ACDF?

Answer 7

Pseudoarthrosis (13% in single level, 30% in multi-level)

Question 8

What is the location of the cervical sympathetic chain in the Smith-Robinson approach?

Answer 8

On the lateral border of the longus coli at C6; injury can cause Horner’s syndrome (anhidrosis, enopthalmous, miosis, ptosis)