Radiculopathy
What is Radiculopathy (RP)?
The spine is made up of many bones called vertebrae. In addition, the spinal cord runs through a canal in the center of these bones. From this cord, nerve roots split and travel between the spinal bones and various parts of the body. When these nerves become damaged or pinched, the resulting condition is called radiculopathy (also known as a pinched nerve).
This condition can have different names based on where it occurs in the spine, such as:
Lumbar (RP): Occurs in the lower back and often involves the sciatic nerve (See sciatica). This is the most common form of the condition.
Cervical (RP): This happens when a nerve root in the neck becomes compressed. Symptoms usually occur in the arms and hands, as these are the areas affected by this portion of the spinal cord.
Thoracic (RP): Caused by a compressed nerve root in the upper back. Patients often feel numbness and pain that wraps around to the front of the body. This is the least common location for pinched nerves.
Compressed nerve roots quickly become inflamed, which can result in the following symptoms:
Sharp pain in the arms, legs, back, or shoulders
Numbness of the skin
Loss of reflexes or weakness in the extremities
Sharp pain while sitting or coughing
Worsening pain with movement
Hypersensitivity
Causes & Risk Factors
(RP) normally occurs when there are changes in the tissues surrounding the nerve roots. These tissues include tendons, intervertebral discs, and spinal vertebrae. When these tissues change in size or shift in position, the space where the nerve roots travel inside the spine narrows. These openings are called foramina. When the foramina narrow, it causes foraminal stenosis, which is very similar to spinal stenosis. In most cases, gradual degeneration of the spine causes foraminal stenosis as we age. That being said, spinal injury can also cause foraminal stenosis.
Herniated Discs
Herniated or bulging discs are a common cause of (RP). Spinal discs act as cushions between the vertebrae, but on occasion they may slip out of place or become damaged. This can put pressure on nerves and can affect areas in the lower back as well as the neck. Read more…
Bone Spurs
Bone spurs are areas of extra bone growth and this can lead to the narrowing of spinal passageways. This can also cause (RP). Bone spurs form in the spine due to inflammation from trauma, osteoarthritis, or other degenerative conditions. Read more…
Other Causes
Thickening of the spinal ligaments can narrow spinal passageways and lead to nerve compression. Though not as common, spinal infections and various cancerous or noncancerous growths in the spine can press against nerve roots. (RP) can also occur in patients who have a family history or genetic predisposition to the condition. Lastly, repetitive improper movements can contribute to the formation of pinched nerves. Such movements occur in those who participate in high-impact sports, heavy lifting, or manual labor.
Diagnosis
More often than not, the patient will need to give their physician a brief medical history. This should give the doctor enough clues to know where to start. After the medical history has been taken, it is usually followed up with physical tests. Physical examinations and tests are used to check the patient’s muscle reflexes and strength. Any pain experienced during a given movement will provide the doctor with clues about the location of the affected nerve root. In some cases, it may be necessary to use imaging tests, such as a CT scan or an MRI. These tests are used to better visualize the structures within the problem areas. Sometimes, a nerve conduction study or an electromyography (EMG) can determine whether the problem is muscular or neurological.
Complications of Surgery
With surgery, there are always going to be risks. Possible complications depend on the approach used, healing, and long-term changes. Before surgery, discuss each of the risks with a certified expert. Although there are always risks, medical experts have many tricks up their sleeves to help minimize them.
Recovery
After surgery, the patient will normally stay in the hospital for 1-2 days. This varies, however, based on the type of surgery and condition you have. Due to the minimally invasive nature of the procedures, scarring is often minimal. Less pain is also felt during recovery as the muscles are moved instead of cut. NSAIDs are recommended for those who still feel pain after treatment. Most patients find that they can eat and walk on the first day after surgery. Solid foods may be difficult to swallow for a few weeks if the neck was the affected area. Hoarseness is also common.
Eligibility For Surgical Treatment
Normally, more conservative treatments are recommended first, such as muscle relaxants, physical therapy, steroid injections, and weight loss regimens. If these options have not given the patient sufficient relief, then surgery may be the next best alternative. That being said, some situations may restrict an individual from receiving surgical care. Patients with spinal infections, serious vertebral instability, or other serious medical conditions are a few possible examples. Working with a qualified physician to examine your condition is the only way to know if surgery is right for you. To learn more, contact our spine experts at The Advanced Spine Center of New Jersey. Our surgical team has years of expertise and training in performing the most state-of-the-art surgical procedures. Reach out to one of our spine experts today!
General risks for any spine surgery include:
Infection
Nerve injury
Bleeding
Spinal cord injury
Reaction to anesthesia
Failure to relieve symptoms
The need for future surgery
Dural tears
Other medical problems, such as lung complications, heart attack, or stroke