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Cervical Radiculopathy
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The most common cause of cervical radiculopathy (in 70–75% of cases) is foraminal encroachment of the spinal nerve due to a combination of factors, including decreased disc height and degenerative changes (i.e., cervical spondylosis; Figure 16.3). In contrast to disorders of the lumbar spine, herniation of the nucleus pulposus is responsible for only 20–25% of cases.
Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Lumbar radiculopathy is also called sciatica since the nerve roots making up the sciatic nerve are often involved. It may be caused by an injury or occur without warning. Often, it is due to a structural abnormality such as a herniated disc or bone spur, or caused by mechanical stretching or trauma. Discs can be damaged by strenuous activity or congenital defects also. Causes of cervical radiculopathy include material from a ruptured disc, degenerative bone changes, arthritis, and injuries that compress the nerve roots. Cervical foraminal stenosis may also be causative. Risk factors include smoking, previous radiculopathy, and lifting heavy items. Thoracic radiculopathy is caused by a compressed nerve root in the thoracic area of the spine. Causative factors include narrowing of the space where the nerve roots exit the spine. This can be due to bone spurs, stenosis, or disc herniation. Radiculopathy is usually a mechanical root compression caused by diabetes mellitus. Diabetic thoracic polyradiculopathy is present in 15% of insulin-dependent patients and in 13% of noninsulin-dependent patients. Other causes include spondylosis, metastatic tumors, trauma, scoliosis, and tuberculosis.
Anterior cervical surgery
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Álvaro Martín Gallego, Chelsie McCarthy, Roger Härtl
Radiculopathy: Symptoms are caused by conditions that affect the nerve roots. Cervical nerve roots provide innervation to a specific region of upper extremities. The nerve root is irritated (by compression) at its exit from the cervical spinal cord. This irritation can result in pain, weakness, numbness, or hyperpathia in the neck or upper extremities. Cervical disc herniation is one of the most frequent causes of cervical radiculopathy. Disc herniations are responsible for only 20%–25% of radiculopathy cases, and approximately 70%–75% are from spondylosis.
Evaluation of percutaneous adhesiolysis for the management of chronic pain due to post spine surgery syndrome
Published in Egyptian Journal of Anaesthesia, 2023
Salah Mostafa Asida, Saeid Elsawy, Mahmoud Faisal, Ossama Hamdy
Minimally invasive procedures are another line for treatment; it includes epidural steroid injections (ESIs) and epidural injections, these two procedures are the most performed surgery in pain clinics worldwide [5]. There are three primary approaches for administering treatments for radiculopathy; transforaminal, interlaminar or caudally. Radiofrequency ablation is often used to produce long-lasting relief that diagnostic blocks or injections cannot achieve. Spinal cord stimulation has shown potential in managing FBSS. Lysis of adhesions can improve baseline pain scores and drug delivery of ESI, which is done by the delivery of hyaluronidase combined with hypertonic saline into the epidural space. Combining hyaluronidase with steroid may be more efficient and have linger impact than either one solely.
Chameleons, red herrings, and false localizing signs in neurocritical care
Published in British Journal of Neurosurgery, 2022
Boyi Li, Tolga Sursal, Christian Bowers, Chad Cole, Chirag Gandhi, Meic Schmidt, Stephan Mayer, Fawaz Al-Mufti
Radiculopathy is a nerve root dysfunction that causes sensory or motor symptoms. Common etiologies include mechanical compression, neuropraxia or chemical irritation of nerve roots.71 Though rare, radiculopathy has been reported as a FLS in intracranial hypertension, particularly in IIH, central venous sinus thrombosis (CVT), and intracranial sinus venous thrombosis (ISVT).8,72 One pathophysiology of this type of radiculopathy is similar to that of cranial nerve neuropathies in intracranial hypertension: elevated ICP in the subarachnoid space causing compression of nerve roots.7,72 Motor roots may be more susceptible to damage as patients tend to have normal sensorium.8,72 Patients can present with headache, papilledema, progressive visual loss, complete ophthalmoplegia, flaccid areflexic quadriparesis, as well as motor weakness and leg pain presenting primarily in herniated lumbar disc patients.8,72 Radiculopathy can be confirmed by electrophysical findings and normal MRI of brain and spinal cord, as well as normal angiography, can exclude other possibilities such as midbrain infarction secondary to deep cerebral venous thrombosis and cavernous sinus thrombosis.8 To avoid misdiagnosis, nerve conduction studies should be viewed carefully, in context with imaging and other ancillary testing.
Outcome and negative events in thoracic disc herniation surgery: a Danish registry study
Published in British Journal of Neurosurgery, 2021
Thea Overgaard Wichmann, Mindaugas Bazys, Gudrun Gudmundsdottir, Jakob Gram Carlsen, Peter Duel, Kestutis Valancius, Niels Katballe, Mikkel Mylius Rasmussen
At baseline, 53 patients presented with radiculopathy and 17 patients presented with myelopathy. Patients with radiculopathy experienced clinical improvement at an approximately equal rate at short- and long-term follow-up (74% versus 75%). Four (8%) patients with radiculopathy experienced deteriorating at short-term follow-up, while 5 (10%) experienced deteriorating at long-term follow-up. Of the 17 patients with myelopathy, the frequency of clinical improvement was greatest at long-term follow-up (65% versus 75%). One patient experienced deterioration at short- and long-term follow-up. Comparing patients with radiculopathy and myelopathy, neither age, symptom duration, surgical approach, location of TDH, nor level of TDH significantly differed. Only age significantly differed between the two groups (p = .008).