Prolapsed cervical disc may be precipitated by local strain or injury - often linked to unguarded flexion and rotation. There is usually a predisposing abnormality of the disc with increased nuclear tension.
Cervical radiculopathy is a clinical condition caused by the compression of the cervical nerve roots.
- patients may complain of pain, sensory deficits, motor deficits, diminished reflexes, or any combination of the symptoms (1).
The annual incidence is reported to be 107 per 100,000 men, and 64 per 100,000 women, and incidence seems to peak during the 4th and 5th decades of life (2)
Several risk factors have been identified:
- white ethnicity
- cigarette smoking
- prior lumbar radiculopathy
- other proposed risk factors include:
- lifting heaving objects
- frequent diving from height
- driving or using vibrating equipment
- playing golf (2)
The condition is caused by compression of the nerve root. Cervical nerve roots may be compressed by:
- herniated nucleus pulposus - in 25% of patients
- three main types of disk herniation have been described:
- intra-foraminal - the most common type, resulting in predominantly sensory radicular symptoms
- posterolateral - results in weakness and potentially muscle atrophy
- midline - rare, resulting in symptoms of myelopathy such as upper extremity numbness, weakness, gait disturbance, ataxia, and urinary incontinence
- The C7 root (C6-7 herniation) is the most commonly affected, followed by the C6 (C5-6 herniation) and C8 (C7-T1 herniation) nerve roots
- foraminal encroachment/degenerative changes (cervical spondylosis) - in 75% of patients
- spondylosis of uncovertebral joint's located anterior to the nerve root tends to affect the anterior aspect of the nerve root while facet joint arthritis affects the posterior aspect of the nerve root.
- decreased disk height due to degenerative loss may also decrease the diameter of the foramen and cause nerve root impingement (1,2,3)
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