DEGENERATIVE CONDITIONS OF THE SPINE Cervical radi

DEGENERATIVE CONDITIONS OF THE SPINE Cervical radiculopathy

Patients present with neck and arm pain (brachialgia), paraesthesia and motor weakness in the distribution of the compromised nerve root (radiculopathy). This may be caused by disc herniation or degenerative stenosis. Symptoms often respond to conservative treatment, including physiotherapy and medication for neuropathic pain (amitriptyline, gabapen - tin or pregabalin), or CT-guided foraminal epidural steroid injections of local anaesthetic and steroid. Intractable pain ). The and/or functional neurological deficit are indications for surgical intervention. Surgical options include anterior cervical discectomy and fusion (using a cage packed with bone graft and plate), cervical total disc replacement ( Figure 37.2 ) or posterior procedures to enlarge the canal such as laminoplasty and laminoforaminotomy . Randomised controlled trials have compared anterior cervical discectomy and fusion with cervical disc replacement. Similar clinical outcomes have been observed in both groups. However, cervical disc replacements preserve motion in the operated level and may protect against adjacent segment disease in the longer term. - DEGENERATIVE CONDITIONS OF THE SPINE Cervical radiculopathy

Patients present with neck and arm pain (brachialgia), paraesthesia and motor weakness in the distribution of the compromised nerve root (radiculopathy). This may be caused by disc herniation or degenerative stenosis. Symptoms often respond to conservative treatment, including physiotherapy and medication for neuropathic pain (amitriptyline, gabapen - tin or pregabalin), or CT-guided foraminal epidural steroid injections of local anaesthetic and steroid. Intractable pain ). The and/or functional neurological deficit are indications for surgical intervention. Surgical options include anterior cervical discectomy and fusion (using a cage packed with bone graft and plate), cervical total disc replacement ( Figure 37.2 ) or posterior procedures to enlarge the canal such as laminoplasty and laminoforaminotomy . Randomised controlled trials have compared anterior cervical discectomy and fusion with cervical disc replacement. Similar clinical outcomes have been observed in both groups. However, cervical disc replacements preserve motion in the operated level and may protect against adjacent segment disease in the longer term. -