Cervical Radiculopathy (pinched spinal nerve in the neck)

Cervical radiculopathy refers to irritation or dysfunction of one or more of the nerve roots that arise from the spinal cord in the neck and travel down into the arm. Symptoms may include pain that radiates down the arm or into the shoulder or shoulder blade, weakness of arm muscles, a loss of sensation (numbness), and tingling in the arm or hand. Patients may have just one or any combination of the above symptoms.

The cause of cervical radiculopathy is compression of a spinal nerve near where it emerges from the spinal cord in the neck. This can be due to a herniated disc or disc bulge, degenerative arthritis, infection, or other problems. Radiculopathy due to certain causes may improve or even resolve with time without the need for surgery (for example, a herniated disc). Symptoms due to other causes may not improve with time - even with medications and physical therapy. Surgery should be considered for patients with bothersome symptoms that have not resolved despite trials of non-surgical treatments, usually including physical therapy and a steroid injection.

For patients with persistent and bothersome symptoms from cervical radiculopathy, surgery represents a definitive treatment option. Most patients who undergo surgery for cervical radiculopathy can expect most or all of their symptoms to improve or resolve, though some symptoms may take longer than others (for example, numbness tends to take longer to improve than pain). There are surgical options from both the front and the back of the neck (i.e. "anterior" and "posterior").

Anterior surgery is used most commonly for cervical radiculopathy. Options include anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (arthroplasty). Posterior approaches include cervical laminectomy/foraminotomy, with or without fusion, and cervical laminoplasty. Each of these options has benefits and drawbacks. The right option for you will depend on your symptoms, the number of spinal levels affected, and factors related to your medical history, smoking status, age, and spinal anatomy.

If you live near Denver and are suffering from cervical radiculopathy, please consider meeting me in consultation to learn more about your treatment options.