Radiculopathies Flashcards
What are radiculopathies?
Disorders affecting spinal nerves or nerve roots, leading to pain, numbness, weakness, or difficulty controlling specific muscles.
What is cervical radiculopathy often caused by?
Degenerative changes that narrow the space where the nerve root exits the spine.
What is lumbar radiculopathy commonly caused by?
Herniated disc.
How does thoracic radiculopathy typically arise?
Less common, can result from herpes zoster.
What does radiculopathy cause?
Compression/irritation of spinal nerve root, causing pain, sensory changes, and/or motor changes.
Which nerve roots are most often affected in cervical radiculopathy?
C6-C7.
What are the most common causes of cervical radiculopathy?
- Spondylosis of facet joints
- Disc herniation
What serious pathologies can cause cervical radiculopathy?
- Vertebral artery dissection
- Cancer
- Infection
- Spinal fracture
What are common clinical features of cervical radiculopathy?
- Radiating pain from cervical spine
- Sensory changes (pain, numbness, paraesthesia)
- Motor changes (paresis, loss of dexterity)
What medications can cause neuropathy?
- Amiodarone
- Carbamazepine
What special examination tests are used for cervical radiculopathy?
- Spurling’s compression test
- Axial traction test
- Arm squeeze test
- Upper limb neural tension tests
What imaging techniques are used to investigate cervical radiculopathy?
- MRI
- X-ray
What is the typical prognosis for cervical radiculopathy?
Good, with symptoms resolving within 4-6 months.
What is the first line of management for cervical radiculopathy?
Conservative management.
What is the most common cause of lumbar radiculopathy?
Herniated disc due to degenerative changes.
Which nerve roots are most commonly affected in lumbar radiculopathy?
L4-S1, termed lumbosacral radiculopathy.
What are the clinical features of lumbar radiculopathy?
- Radiating pain from lumbar spine
- Sensory changes (numbness, paraesthesia)
- Motor changes (paresis, loss of strength)
What medical history factors are associated with lumbar radiculopathy?
- Low back pain
- Degenerative disc disease
- Previous disc herniation or prolapse
What special examination tests are used for lumbar radiculopathy?
- Slump test
- Straight leg raise
What is the prognosis for lumbar radiculopathy?
Generally good, most cases resolve within 12 months.
What are some surgical management options for lumbar radiculopathy?
- Discectomy
- Spinal decompression
- Open laminectomy with discectomy
What complications can arise from lumbar radiculopathy?
- Pain
- Central sensitization
- Muscle atrophy and deconditioning
- Progressive limb weakness
- Cauda equina syndrome
Sensory loss over anterior thigh.
Weak hip flexion, knee extension & hip adduction.
Reduced knee reflex.
Positive femoral stretch test.
L3 nerve root compression
Sensory loss anterior aspect of knee and medial malleolus.
Weak knee extension & hip adduction.
Reduced knee reflex.
Positive femoral stretch test.
L4 nerve root compression
