Cervical Radiculopathy

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, weakness of corresponding 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 often compression of a cervical nerve root where it emerges from the spinal cord. This can be due to a herniated disc, degenerative arthritis, infection, or other problems. Certain causes may resolve with time (for example, a herniated disc), while others tend not to improve with time - even with medications and physical therapy. Surgery should be considered for patients with severe symptoms that have not resolved despite trials of several non-surgical treatments over an adequate period of observation.

In terms of surgery, there are options from both the front and the back of the neck (i.e. "anterior" and "posterior").

Anterior options for surgery include anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (arthroplasty). Posterior approaches include cervical laminectomy with or without fusion and 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, age, and spinal anatomy.

Lumbar Radiculopathy

Lumbar radiculopathy refers to irritation or dysfunction of one or more of the nerve roots that arise from the spinal cord in the low back and travel down into the leg. Colloquially, lumbar radiculopathy is often referred to as sciatica. Symptoms may include pain that radiates down the leg, weakness of leg muscles, a loss of sensation (numbness), and tingling in the leg or foot. Patients may have just one or any combination of the above symptoms.

Some causes of lumbar radiculopathy, such as a herniated lumbar disc, may improve on their own over time without surgery. Other problems are less likely to improve with time. Physical therapy, medication, steroid injections, and yoga therapy all have a role to play in helping symptoms. For patients who do not find relief from these measures, surgery should be considered.

As with cervical radiculopathy, treatment is focused on removing pressure from the affected nerve roots. Some patients may need only a laminectomy or removal of bone around the affected nerve root, a procedure called a foraminotomy, while others may need a spinal fusion to correct instability in the spine. Your symptoms, medical history, MRI findings, and X-rays will all factor in to this decision.