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Cervical Spine Disc Disease & Cervical Myelopathy

Categorization By Odom et al

Unilateral soft disc protrusion

Nerve root compression /radiculopathy

Osteophytes /hard disc

Nerve root compression /radiculopathy

Medial soft disc protrusion

Spinal Cord compression / myelopathy

Cervical spondylosis

Spinal Cord compression/ myelopathy

Cervical Radiculopathy

Definition

A condition caused by compression of a nerve root in the cervical spine

Incidence

Annual incidence is 83.2 per 100000 population (reported in 1994 by Radhakishran, Minnesota, 1994)

Age - Not common in under 30s. Most common in 40s and 50s. Cervical degeneration tends to begin 10 years later than lumbar spine degeneration

Sex - F:M = 3:2

Pathology

  • Lateral  Disc herniation  approx. 50% (soft disc)

  • Osteophyte formation in Lushka (intervertebral body joint or facet joint approx. 50% (hard disc)

  • Only 5% also have developmental spinal stenosis (AP diameter of spinal canal of  12mm or less)

  • Compression occurs mostly at the entrance or just medial to the foramen where the nerve roots pass ventrally to the superomedial edge of the superior articular process. Occasionally a herniated disc will migrate into the intervertebral foramen

  • Frequency of nerve root compressed C7>C6>C8>C5



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