Orthopaedic Conditions

CONDITIONS OF THE SPINE

• Cervical Radiculopathy

Radiculopathy is a common problem that results when nerve roots are compressed or irritated. It is the sensation of pain (usually a burning sensation), numbness, or tingling that follows a nerve from the spine to the extremities. This can occur anywhere along the spine from the neck to the low back. In the cervical spine it begins in the neck and can travel to the shoulders, between the shoulder blades, and into the arms and/or hands. It is often referred to generically as "Sciatica" when the pain travels down the leg from the lumbar spine (lower back). These symptoms can be due to a variety of causes such as disc bulges, degenerative narrowing of the space for the nerves (spinal stenosis or foraminal stenosis), spinal instability or deformity of the vertebrae, or herniation of fragments of disc material outside of the disc space (herniated discs). In 70-80% of patients, sciatica is transient, and resolves with nonsurgical treatments such as antiinflammitory medications, physical therapy, exercise, spinal manipulation, or other nonsurgical modalities. A proportion of patients with upper extremity radiculopathy or sciatica require surgical intervention in instances where non-surgical therapies have failed to provide adequate pain relief and there is pathology that is present compressing the nerves. A very small proportion of patients require urgent surgery. If a very large cervical or lumbar disc herniation causes severe nerve damage with paralysis or acute bowel or bladder incontinence, then emergency surgery may be required.