Cervical Disc

Cervical disc disease

Cervical Disk Disease Herniation of a lower cervical disk is a common cause of neck, shoulder, arm, or hand pain. Neck pain (worse with movement), stiffness, and limited range of neck motion are common. With nerve root compression, pain may radiate into a shoulder or arm. Extension and lateral rotation of the neck narrows the intervertebral foramen and may reproduce radicular symptoms (Spurling's sign). In young people, acute cervical nerve root compression from a ruptured disk is often due to trauma. Subacute radiculopathy is less likely to be related to a specific traumatic incident and may involve both disk disease and spondylosis. Cervical disk herniations are usually posterolateral near the lateral recess and intervertebral foramen. The usual patterns of reflex, sensory, and motor changes that accompany specific cervical nerve root lesions are listed in Table 16-2. When evaluating patients with suspected cervical radiculopathy it is important to consider the following: (1) overlap in function between adjacent nerve roots is common, (2) the anatomic pattern of pain is the most variable of the clinical features, and (3) the distribution of symptoms and signs may be evident in only part of the injured nerve root territory.

Table 16-2: Cervical Radiculopathy-Neurologic Features