Treatment of cervical spondylotic radiculopathy: targeted treatment is the most important

If radiculopathy is not serious, surgery is not required. Massage and acupressure can be used for treatment. If these treatments are ineffective, surgical treatment should be considered in time. If surgical treatment is not performed in time, it will affect daily work and life.

1. Treatment of cervical spondylotic radiculopathy

1. Non-surgical treatment

Various targeted non-surgical treatments have obvious therapeutic effects, among which continuous (or intermittent) traction of the head and neck, neck immobilization and correction of improper posture are particularly important. Manual massage also has certain therapeutic effects, but it should be gentle, and accidents caused by rough operation should be avoided. Massage and pushing should not be used.

2. Surgical treatment Surgery can be considered for those with the following conditions:

(1) The patient has not responded to regular non-surgical treatment for more than 3 months, and the clinical manifestations, imaging findings, and neurological localization are consistent.

(2) There is progressive muscle atrophy and severe pain.

(3) Although non-surgical treatments are effective, recurrent symptoms can affect work, study, and life.

2. Symptoms and Signs

1. Neck symptoms

The severity of the root compression may vary depending on the cause. Those mainly caused by nucleus pulposus herniation are often accompanied by obvious neck pain, paraspinal muscle tenderness and upright neck position due to direct stimulation of the local sinus nerve. Direct tenderness or percussion pain on the cervical spinous process or between the spinous processes are mostly positive, and these manifestations are particularly obvious in the acute stage. If it is caused by simple atlantoaxial joint degeneration and bone hyperplasia, the neck symptoms will be mild and there may even be no special findings.

2. Radicular pain

The most common type, its range is consistent with the distribution area of ​​the spinal nerve roots of the affected vertebrae. At this time, it must be distinguished from dry pain (mainly radial nerve trunk, ulnar nerve trunk and median nerve trunk) and plexus pain (mainly cervical plexus, brachial plexus and axillary plexus). Accompanying radicular pain are other sensory disturbances in the distribution area of ​​the nerve root, among which numbness of the fingers, hyperesthesia of the fingertips and decreased skin sensation are the most common.

3. Radicular muscle dysfunction

It is more obvious in those whose anterior roots are compressed first. In the early stage, muscle tension increases, but it soon weakens and muscle atrophy occurs. The affected area is also limited to the muscle group innervated by this spinal nerve root. In the hands, the thenar and hypothenar muscles and interosseous muscles are the most obvious. It also needs to be distinguished from trunk and plexus muscular atrophy, and from muscle strength changes caused by spinal cord lesions. If necessary, electromyography or cortical evoked potential tests can be performed for identification.

4. Changes in tendon reflexes

That is, the reflex arc involved in the affected spinal nerve root is abnormal. It is active in the early stage, but decreases or disappears in the middle and late stages. It should be compared with the contralateral side during examination. Simple root involvement should not cause pathological reflexes. If accompanied by pathological reflexes, it means that the spinal cord is also affected.