Understanding the problem
Radiculopathy is a term used to describe conditions which have caused damage to the nerve roots which connect the spine to the rest of the nervous system. A well-known form of radiculopathy is sciatica. The condition can also be caused by diseases or bacterial infections, and injuries to the spine, especially injuries which compress the vertebrae. Radiculopathy is characterized by pain, numbness, and weakness which radiates from the spine. When radiculopathy is diagnosed, doctors usually determine whether it is cervical, located in the neck, thoracic, located in the middle back, or lumbar, located in the lower back.
Sometimes, the cause cannot be identified, in which case the patient’s condition is termed idiopathic radiculopathy.
Understanding who suffers
In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement or nerve compression at the foramen of an existing nerve ( foramen is a hole in the spine that the nerve roots exit from the spinal cord to the rest of the body).
Disc herniation accounts for 20-25% of the cases of cervical radiculopathy. In the older patient, cervical radiculopathy is often a result of foraminal narrowing from bone spurs, decreased disc height, degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly.
Factors associated with increased risk include heavy manual labor requiring the lifting of more than 25 pounds, smoking, and driving or operating vibrating equipment.
Potential Signs and Symptoms
Cervical radiculopathy can present acute pain, as with a traumatic ruptured disc, or can present pain of a more chronic and intermittent nature, as is seen in foraminal narrowing caused by bone spurs in the spine.
Typically, cervical radiculopathy affects the inferior nerve root at level of the spine, C5, C6 and C7 levels. Symptoms that can have present at different levels include:
- Deltoid weakness Pain in the shoulder and the upper part of the lateral arm
- Paraesthesia in the more distal part of the affected dermatome
- Weakness in Biceps or Brachioradialis (the muscle of the forearm that flexes the forearm at the elbow)
- Hyporeflexia (below normal sensory reaction) Paresthesias (abnormal sensation, typically tingling or pricking) and sensory loss more distal from the source of injury, and can extend into the hand
- Pain extending into the distal forearm
- Hand nerve root compression which produces triceps weakness and a decreased triceps reflex
- Sensory loss in the hand
Examinations Usually Required
Radiography of the cervical spine is usually the first diagnostic test ordered in patients who present with neck and limb symptoms.
CT scanning provides good visualization of bony elements and can be very helpful.
Magnetic Resonance Imaging (MRI):
MRI has become the method of choice for imaging the neck to detect significant soft-tissue pathology.
Electro diagnostic studies are important in identifying physiologic abnormalities of the nerve root and in ruling out other neurologic causes.
Proposing Treatment and Why AIMIS
When symptoms of cervical radiculopathy persist or worsen surgery may be recommend.
The primary goal of surgery is to relieve symptoms by decompressing, or relieving pressure on, the compressed nerves in the neck.
AIMIS performs a large number of procedures for this disease area including:
- Minimally Invasive Cervical Discectomy and Fusion
- Minimal Invasive Nerve Decompression Surgery
- Artificial Disc Replacement Surgery
- Posterior Cervical Foraminotomy
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Reputable and Prestigious Surgeons
AIMIS' skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world of treating cervical radiculopathy. Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment.
Getting More Information Before Moving Forward
You may have questions like:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
What AIMIS Can do:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.
AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
Further information on the problem:
This condition is an irritation or compression of one or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, an injury in the cervical spine can cause symptoms in these areas.
Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column.
One common cause is a herniated disc. A herniated disc is a rupture in the fibrous outer wall of a vertebral disc, which allows the soft nucleus of the disc to bulge outward. This bulge can press harmfully against a nerve root.
Degenerative Disc Disease
Another common cause of nerve root injury is degenerative disc disease. It occurs when a spinal disc weakens, allowing vertebral bones above and below the disc to shift out of position. The bones can touch, pinching nearby nerve roots.
When bones, discs or joints of the spine degenerate, bony spurs may form and push into the spinal canal or foramen space. This is called spinal stenosis, and it can also create harmful pressure against the spinal cord or nerve roots.
Further Information on Increased Risk Groups
Factors associated with increased risk include:
- heavy manual labor requiring the lifting of more than 25 pounds
- long hours of driving or operating vibrating equipment.
Other, less frequent causes include:
- tumors of the spine
- expanding cervical synovial cyst
- synovial chondromatosis in the cervical facet joint (a condition of the thin layer of tissue that lines joints)
- giant cell arteritis of the cervical radicular vessels (a condition causing inflammation of the lining of arteries)
- spinal infections.
Further examination that maybe required or requested
Radiography of the cervical spine is usually the first diagnostic test ordered in patients who present with neck and limb symptoms, and more often than not, this study is diagnostic of cervical disc disease as the cause of the radiculopathy. The American College of Radiology recommends plain radiographs as the most appropriate initial study in all patients with chronic neck pain. Lateral, anteroposterior, and oblique views should be ordered.
CT scanning provides good visualization of bony elements and can be helpful in the assessment of acute fractures. It can also be helpful when C6 and C7 cannot be clearly seen on traditional lateral radiographic views.
The accuracy of CT imaging of the cervical spine ranges from 72-91% in the diagnosis of disc herniation.
Magnetic Resonance Imaging (MRI):
MRI has become the method of choice for imaging the neck to detect significant soft-tissue pathology, such as disc herniation.
The American College of Radiology recommends routine MRI as the most appropriate imaging study in patients with chronic neck pain who have neurologic signs or symptoms but normal radiographs. MRI can detect ligament and disc disruption, which cannot be demonstrated by other imaging studies. The entire spinal cord, nerve roots, and axial skeleton can be visualized. This study is usually performed in the axial and sagittal planes.
Electro diagnostic studies are important in identifying physiologic abnormalities of the nerve root and in ruling out other neurologic causes for the athlete's complaints. EMG has been shown to be useful in the diagnosis of radiculopathy and has correlated well with findings on myelography and surgery.
Why AIMIS for this Surgery
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
Other Services Provided by AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you’ll know the best flights to take, where you’ll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become “part of our family” and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.