Cervical Radiculopathy - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубліковано 3 січ 2019
- Dr. Ebraheim’s educational animated video describes the condition of cervical spine radiculopathy.
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Cervical Radiculopathy
Cervical radiculopathy is caused by cervical nerve root compression. The patient will have pain and/or progressive neurological deficit that results from conditions such as disc herniation that irritates a nerve in the cervical spine. Cervical radiculopathy is an irritation of the cervical nerve root. Cervical spine and shoulder problems overlap. The condition is of cervical spine etiology if the patient’s symptoms are relieved by shoulder abduction, by placing the hand over the head. The relief of the symptoms occurs due to decreased tension on the nerve roots. In cervical disc problems, be aware of false positive MRIs especially if the patient is above the age of 40 years old. Nerve conduction studies are not useful; they have a high false negative rate. EMG and nerve studies may differentiate radiculopathy from peripheral nerve entrapment. Cervical disc problems usually affect the lower numbered nerve root. When you see the middle finger numbness, then this is C7. When compression of the C7 nerve root, there will be middle finger numbness, triceps weakness, and the triceps reflex will be affected. The cervical nerve roots are horizontal in orientation. It does not matter if cervical disc herniation is central or foraminal, it will compress the same nerve root. C7 nerve root runs above the pedicle of the C7 vertebra. C5-C6 is the most commonly affected disc and that will compress the C6 nerve root. The patient will come to the doctor with unilateral arm pain that is relieved by arm elevation. The numbness and paresthesia will occur in specific dermatomes. The patient may also have upper trapezius pain or interscapular pain. The patient may complain of occipital headache. When you examine the patient, do provocative tests such as the spurling’s test and the shoulder abduction test. The Spurling’s test is done by extending and rotating the neck towards the involved side. It reproduces the symptoms by narrowing the neuroforamen. The Spurling’s test differentiates cervical radiculopathy from peripheral nerve entrapment. Lifting the arm above the head relieves the symptoms if the cervical nerve roots are irritated. The Shoulder Abduction test differentiates cervical pathology from other causes of painful shoulder etiology. Make sure that you do not have a double crush syndrome, one in the neck and one in the peripheral nerve. Make sure that you differentiate radiculopathy from myelopathy. Make sure that you exclude a coexisting myelopathy. Examine the patient for upper motor neuron signs or cervical myelopathy. Test the patient for gait instability. Test the patient for Hoffman’s sign. Test the patient for Babinski reflex. Test the patient for ankle Clonus. Check to see if the patient has hyperflexia in the upper and lower extremities (triceps/quadriceps). Even if there is a bad cervical spine disc problem on the MRI, treat it conservatively for about 3 months. Give the patient therapy and nonsteroidal anti-inflammatory medication (NSAIDS). 75% of the patients will improve with nonoperative treatment. Cervical radiculopathy is generally treated nonoperatively, in contrast to cervical myelopathy. Do surgery when there is persistent, severe pain for 6-12 weeks and/or progressive neurological deficit such as weakness or numbness. The procedure to treat cervical radiculopathy surgically is usually done anteriorly with direct removal of the lesion that causes the radiculopathy such as a herniated disc or spurs. When you place the anterior bone graft or the allograft in the disc space, you open the nueroforamen, and that will indirectly relieve the nerve. Then you will add the anterior plate. Some surgeons prefer to do a posterior approach.
I don't understand how someone could dislike your videos. Great information, really practical and daily work transferable. Keep doing this, very helpful Doc!
Alberto - Thank you
This is the Best Ever explanation of my hand & arm issues. Thanks SO much.
Clearly one of the best teachers out there, you make such a complicated subject so easy , love those animated videos .
THANK YOU PROF. DR. NABIL FOR THIS EXCELLENT EXPLANATION 🎉🎉🎉
So explicitly explained .
Thankyou so much for the trouble you hace taken sir.
May god bless you and your family .
excellent way to explain the cervical radiculopathy.
thank you
Doc, thank you so much for this educational video, it helps greatly!
Excellent and simplified. God bless you Dr Nabil.
Thank you Dr. Ebraheim, this is a GREAT video! I wish I'd have found this 3 months ago when my condition started... Not sure it would have changed the course of my treatment, but I certainly would have been much more informed...
This is an excellent video. I was just diagnosed with this condition. I love how you broke this down. I subscribed.
Cannot thank you enough sir. You are one of the rare ones across the world who is generous and willing to teach. Gracias ❤
This was very helpful. I appreciate it!
Much appreciated - a much easy summary than what my consultant provided.
This was invaluable to me as someone who has been diagnosed with cervical nerve compression. It helped me make sense of my MRIs so I'm more informed of what to expect when I see my neurologist. Clear, concise, and to the point. Thank you!!!
Thank you so much for posting this video!
Thank you so much for the video .It was very helpful.
Thank you, Dr. Ebraheim for this information. It helped me understand my condition better. I am currently under physical therapy and medication because of cervical radiculopathy that causes me to have neuropathic pain. Your explanation helped me understand why I feel painful pins and needles on certain parts of my hands and back in relation to C6 and C7 as what I have also heard from my doctor. Thank you.
Doctor Ebraheim, you are amazing!! Please keep up the awesome work...I am learning so much more than from a book or even other UA-cam channels. I think you were put here on earth to help people both on the operating table and beyond!! You are a natural as a teacher and you've been blessed - thanks for blessing us as well!!
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I stupidly lost the login password. I appreciate any assistance you can offer me
@Mathew Wesson instablaster :)
@Mathias Hunter Thanks so much for your reply. I got to the site on google and I'm trying it out atm.
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Thank you so much you saved my ass!
@Mathew Wesson happy to help xD
Thank you so much for your videos. They are so helpful!
Your videos are amazing. So informative and helpful. God bless you Dr Nabil. I only wish you were my physician.
Just let say your explanations are really easy to understand thank you 😊
Excellent explanation. Very clear. Thank you so much!
Thank you Dr. It's very clear and informative.
Thanks Doctor... This video is informative, thoroughly enjoyed learning from it.
Very thankful for this video. It helped me understand my condition better.
Just going through this myself, been told got to have an operation 😢
You absolutely wonderful man. Thank you, Dr.
Thank you! Very well explained.
Very helpful tomorrow I have presentation and it's going to be helpful. Thanks alot!!
Excellent Demonstration Sir
Thank you Doctor for this valuable information. It is very helpful.
Thanks for your very precise information. It is very useful.
Your videos are so helpful. Would you please consider producing some videos on ordering physical therapy?
I appreciate your simplified explanations, now I am better prepared to discuss my options (cervical stenosis, herniated c4-c5-c-6-c7,foraminal stenosis too).
Thanks Dr for the very useful information.
Tnank you very much sir.. God bless you for your effort
It's very helpful. Thanks
It's very helpful
Thank you for your effort 💖
A GREAT PRESENTATION !!! THANKS JOHN
Amazing, very interesting, very knowledgeable videos
Thank you! Can you please advise on the exercises to treat the issue is in C6, C7. thanks again.
Very helpful style . God bless you sir
You're videos helped me in ortho and even now as a provider
I love your lessons they are the best!!!! :) thank you so much!!!!
Brilliant. I've had what I believed to be a trapped nerve in my neck for about a week. I now know the issue is likely a C6 root nerve irritation due to the dermatone affected. Amazing work!
Hi. How are you feeling now ?
EXCELLENT. THANK YOU FOR SHARING.
Extremely helpful and clear
Very helpful video. Thank you!
very informative thank you.
Fantastic explanation great job 👌👏👏
I found your information to be very helpful! Have been researching for a few months now and this is the best in explanation. Your diagrams are clear and relatable to a non medical person. Thank you.
Very informative. I been dealing with these problems for years. Never total relief injured neck wrestling in high school back in the 70,s. Retired now and only answer is surgery. Most info in such a short video. Both my sons in there forties have spine arthritis and my oldest son that is 6 ft.6 had to have plate in his neck 5 years ago with some permanent drop foot. If arthritis is in your family any spine injury at any age can come back and haunt you latter in life.
best teacher ever
Thank u so much Dr ....this video very helpful to me ....u well explained 👌
Heartly thank you doctor,
شكرا لجهودك
U r the bst teacher!! I seeen🙏🤩
I love it ! More ! More ! More videos like this !
Excellent. Thank you Sir.
best explanations ever!
Thank you.
Thank You!
Very useful film!
Thank you, that was excellent!
Sir..u r d best ortho teacher..tnx a lot sir..keep us uploading with many more worthful videos🙏💐
Thank you so much doctor… 🙏
Thank you, crystal clear. I’m up for surgery in my neck next week🥹.
Thank you
That was very clearly helpful
Great explain. I got many of things to diagnose patients as a doctor
Thank you!
Thank you so much for details
Yes very helpful. Thank you.
Very helpful! Keep making videos please!!!!!!!!!
Thank you so much ..This video was very informative..I also share it with my friends..✨
Very good content Dr.
جزاك الله خير وكتب اجرك بالعلم النافع
Great⭐⭐🥇
ان الله لا يضيع أجر من أحسن عملا ........ صدق الله العظيم
C5
Two drs let me go with bone spurs (since 2018) another one over one year with a pinched nerve with a negative nerve conduction test!! Now after two ACDFs I'm going to have to get a third neck surgery. I'm glad I came across your video.... My best friend has also had a false negative nerve conduction test.. I'm a former EMT and I'm not happy with any of these two drs.
What is the solution for this?any idea? Pls help. Im dying due to pain.
@@AbcDef-fd7kg Make sure you keep this video. Get yourself a neurosurgeon or orthopedic surgeon who listens to you about your pain and will do the appropriate tests. If they are not following standard treatment for your c spine pain, get another Dr who will listen to you. This video may be the one to show them. Best to you!!
Many thanks! 🙏🏼
Easy to understand
Doctor ebraheim you are the master of being concise and precise with all of your topics once again. Thank you very much
thank you so much
I will be so glad when I have surgery next month, this pain is killing me and I’m tired of taking muscle relaxers and pain meds
Thank you ❤
Thank you so much! New DPT here 🤩
great talk but as a pain doctor i'd add a few things to treatment. First NSAIDS / anti inflammatories are often not effective for nerve pain. Try nerve pain medications such as amitriptyline/ nortriptyline, duloxetine or pregabalin/ gabapentin. Second there is the option of epidural injections / pulsed radiofrequency for symptoms that don't improve with medication before going on to surgery.
There is no speciality called pain doctor so keep your options for yourself
Thankyou so muchhh sir
Good, thanks
thank you sir
Excelente gracias
Thanks doc I needed this so now I understand better! I’m having to be operated on as had an issue for over 7 months now 😢
thankyou
Good info
What test is that. I am so annoyed with my docs not treating me well.
Thank you very much 🇯🇲 one love
you are awesome best regards from turkey💕
thank u very much ♥️
Thank you Dr Nabil Ibrahim very good work jazzak Allah . I'm from Pakistan 🇵🇰
Thanke you so much 🙏💖
U R The best in the world 👑
يعطيك العافيه جدا واضح
Video Thật tuyệt vời .Cảm ơn bác sĩ.
thnx a lot