Management of cervical radiculopathy

Cervical monoradiculopathy occurs most commonly at C5-6 and C6-7. It is due mostly to acute herniation of nuclear material. The syndrome often responds to conservative prescription but when surgery is indicated, the results are good. The neurologic examination is the most specific and sensitive clinical test. Acute radiculopathies due to herniated nucleus are, in our hands, best approached via a posterior muscle-splitting incision. Chronic radiculopathies due to osteophyte formation may be approached either anteriorly or posteriorly. Reflex discogenic pain requiring anterior fusion exist but are less common. These patients must be carefully screened because of the functional factors involved.