Cervical Radiculopathy

Roth, Daniel; Mukai, Ai; Thomas, Priya Treesa; Hudgins, Thomas H.; Alleva, Joseph T.

doi:10.1016/j.disamonth.2009.06.004

Cited by 25 publications

(12 citation statements)

References 38 publications

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“…With regard to criteria for the inclusion of patients, many authors stress the value of elaborate history taking [9, 34]. Except on pain, however, we found no specific mentioning of history taking being included in the diagnostic criteria of studies.…”

Section: Discussionmentioning

confidence: 62%

Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

et al. 2012

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PurposeCervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.MethodsWe electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and CINAHL. Studies were included when evaluating conservative interventions in randomised clinical trials (RCTs) in patients with CR. Selection criteria and definitions for patients with CR were extracted and evaluated on their uniformity.ResultsThirteen RCTs were included. Pain was used as an inclusion criterion in 11 studies. Inclusion based on the duration and location of pain varied between studies. Five studies used sensory symptoms in the arm as inclusion criterion. Four studies used cervical range of motion and motor disturbances as inclusion criteria, while reflex changes were used in two studies. Three studies included patients with a positive Spurling’s test and two studies used it within a cluster of provocation tests.ConclusionsCriteria used to select patients with CR vary widely between different intervention studies. Selection criteria and test methods used are poorly described. There is consensus on the presence of pain, but not on the exact location of pain.

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Section: Discussionmentioning

confidence: 62%

Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

et al. 2012

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“…Seventy patients with spinal pain could not recall a specific onset of their pain, therefore it was not possible to establish an exact temporal link between history and pain distribution. An insidious onset is common for the development of pain associated with spinal degenerative changes [59] and it was determined that these cases therefore satisfied Criterion 2.…”

Section: Criterionmentioning

confidence: 99%

Identification of neuropathic pain in patients with neck/upper limb pain: Application of a grading system and screening tools

Tampin

Briffa

Goucke

et al. 2013

Pain

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The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain has proposed a grading system for the presence of neuropathic pain (NeP) using the following categories: no NeP, possible, probable, or definite NeP. To further evaluate this system, we investigated patients with neck/upper limb pain with a suspected nerve lesion, to explore: (i) the clinical application of this grading system; (ii) the suitability of 2 NeP questionnaires (Leeds Assessment of Neuropathic Symptoms and Signs pain scale [LANSS] and the painDETECT questionnaire [PD-Q]) in identifying NeP in this patient cohort; and (iii) the level of agreement in identifying NeP between the NeuPSIG classification system and 2 NeP questionnaires. Patients (n = 152; age 52 ± 12 years; 53% male) completed the PD-Q and LANSS questionnaire and underwent a comprehensive clinical examination. The NeuPSIG grading system proved feasible for application in this patient cohort, although it required considerable time and expertise. Both questionnaires failed to identify a large number of patients with clinically classified definite NeP (LANSS sensitivity 22%, specificity 88%; PD-Q sensitivity 64%, specificity 62%). These lowered sensitivity scores contrast with those from the original PD-Q and LANSS validation studies and may reflect differences in the clinical characteristics of the study populations. The diagnostic accuracy of LANSS and PD-Q for the identification of NeP in patients with neck/upper limb pain appears limited.

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“…2 This study estimated the annual incidence of cervical radiculopathy to be 107.3 per 100,000 for men and 63.5 per 100,000 for women. 4 3 Risk factors that have been associated with the development of cervical radiculopathy include white race, cigarette smoking, and prior lumbar radiculopathy.…”

Section: Epidemiologymentioning

confidence: 99%

Local Bone Only

Sasso¹,

Smucker²

2015

Journal of Spinal Disorders & Techniques

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Cervical radiculopathy is a relatively common neurological disorder resulting from nerve root dysfunction, which is often due to mechanical compression; however, inflammatory cytokines released from damaged intervertebral disks can also result in symptoms. Cervical radiculopathy can often be diagnosed with a thorough history and physical examination, but an magnetic resonance imaging or computed tomographic myelogram should be used to confirm the diagnosis. Because of the ubiquity of degenerative changes found on these imaging modalities, the patient's symptoms must correlate with pathology for a successful diagnosis. In the absence of myelopathy or significant muscle weakness all patients should be treated conservatively for at least 6 weeks. Conservative treatments consist of immobilization, anti-inflammatory medications, physical therapy, cervical traction, and epidural steroid injections. Cervical radiculopathy typically is self-limiting with 75%-90% of patients achieving symptomatic improvement with nonoperative care. For patients who are persistently symptomatic despite conservative treatment, or those who have a significant functional deficit surgical treatment is appropriate. Surgical options include anterior cervical decompression and fusion, cervical disk arthroplasty, and posterior foraminotomy. Patient selection is critical to optimize outcome.

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Cervical Radiculopathy

Cited by 25 publications

References 38 publications

Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

Identification of neuropathic pain in patients with neck/upper limb pain: Application of a grading system and screening tools

Local Bone Only

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