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Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
Spinal Nerves: Anatomy01:23

Spinal Nerves: Anatomy

Spinal nerves are pivotal conduits in the nervous system, bridging the central nervous system (CNS) with the peripheral nervous system (PNS). These nerves enable a complex communication network between the brain, spinal cord, and the rest of the body, facilitating sensory input, motor output, and autonomic functions.
There are 31 bilateral pairs of spinal nerves, each emerging from the spinal cord through the intervertebral foramina—openings between adjacent vertebrae. These nerves are...
The Spinal Cord01:54

The Spinal Cord

The spinal cord is the body’s major nerve tract of the central nervous system, communicating afferent sensory information from the periphery to the brain and efferent motor information from the brain to the body. The human spinal cord extends from the hole at the base of the skull, or foramen magnum, to the level of the first or second lumbar vertebra.
Spinal Nerves: Plexus II01:21

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...

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Related Experiment Videos

4. Cervical radicular pain.

Jan Van Zundert1, Marc Huntoon, Jacob Patijn

  • 1Department of Anesthesiology and Multidisciplinary Pain Centre, Ziekenhuis Oost-Limburg, Genk, Belgium. jan.van.zundert@zol.be

Pain Practice : the Official Journal of World Institute of Pain
|October 8, 2009
PubMed
Summary

Cervical radicular pain, affecting 1 in 1,000 people, is diagnosed using clinical assessment. Interventional treatments like epidural corticosteroids and radiofrequency offer options when conservative care fails.

Related Experiment Videos

Area of Science:

  • Neurology
  • Pain Management
  • Spinal Cord Medicine

Background:

  • Cervical radicular pain originates from irritated cervical spinal nerves or roots, impacting approximately 0.1% of the population.
  • Diagnosis relies on patient history, clinical examination, and potentially imaging or electrophysiologic tests, as no gold standard exists.

Observation:

  • Medical imaging findings may not correlate with pain intensity.
  • Selective diagnostic blocks can confirm the causative nerve root level.
  • Conservative treatments include medication and physical therapy, with limited evidence for specific drug efficacy or traction.

Findings:

  • Interlaminar cervical epidural corticosteroid injections are recommended for subacute cervical radicular pain (2B+).
  • Transforaminal injections are not recommended due to a negative trial and adverse events (2B-).
  • Pulsed radiofrequency treatment is recommended for chronic pain (1B+), with conventional radiofrequency as a secondary option (2B+).

Implications:

  • Interventional treatments provide viable options for managing cervical radicular pain when conservative methods are ineffective.
  • Spinal cord stimulation is a consideration for refractory cases in specialized centers.
  • Further research is needed to establish definitive treatment guidelines and assess long-term outcomes.