Cervical Radiculopathy
Compression or inflammation of a cervical nerve root producing dermatomal arm pain with or without motor and reflex changes.
Overview
Cervical radiculopathy arises from nerve root compression by a disc herniation, osteophyte, or foraminal stenosis. Soft disc herniations predominate in younger patients, while cervical spondylosis with uncovertebral and facet hypertrophy dominates in older adults. C6 and C7 roots are most frequently affected.
Epidemiology
Annual incidence is around 85 per 100,000, with a peak in the fifth decade. Men are affected slightly more often than women. C7 radiculopathy accounts for roughly 60 percent of cases.
Symptoms
Unilateral arm pain in a dermatomal distribution, often worse with neck extension and rotation toward the affected side (positive Spurling test). Weakness, sensory loss, and reflex changes correspond to the involved root. Shoulder abduction relief and neck distraction tests support the diagnosis.
Imaging
MRI is the imaging standard, demonstrating the level and cause of compression. CT myelography is used when MRI is contraindicated or bony detail is essential. Electrodiagnostic studies help localise the lesion and exclude peripheral neuropathy.