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Cervical radiculopathy
M R Ellenberg1, J C Honet, W J Treanor
1Department of Rehabilitation Medicine, Sinai Hospital, Detroit, MI 48235-2899.
Archives of Physical Medicine and Rehabilitation
|March 1, 1994
Summary
Cervical radiculopathy, often caused by disc herniation or spondylosis, can typically be diagnosed via history and physical exam. Most cases improve with conservative treatment, avoiding surgery.
Area of Science:
- Neurology
- Orthopedics
- Spinal Medicine
Background:
- Cervical radiculopathy, recognized early in the 20th century, was linked to disc pathology in the mid-1930s.
- Common causes include disc herniation and cervical spondylosis.
- A comprehensive review of literature from the past decade was conducted.
Purpose of the Study:
- To review the history, pathoanatomy, pathophysiology, clinical presentation, diagnosis, and treatment of cervical radiculopathy.
- To synthesize current knowledge on managing this spinal nerve condition.
Main Methods:
- Literature search of Medline (10-year period).
- Review of bibliographies from textbooks and retrieved articles.
- Synthesis of information on diagnostic and therapeutic approaches.
Main Results:
- Diagnosis is often achieved through patient history, physical examination (including Spurling's maneuver), and manual muscle testing.
- Imaging (MRI, CT, myelography) is valuable for presurgical evaluation or when non-disc/spondylosis etiologies are suspected.
- Electromyography aids in differentiating similar conditions and lesion dating.
Conclusions:
- Cervical radiculopathy typically improves with non-surgical management, with surgery indicated for intractable pain, progressive weakness, or myelopathy.
- Further prospective studies are needed to optimize cost-effective evaluation and care.
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