Literature Review
LtCol Howard Gill, Robert S. Wainner
Study Design: Qualitative, comprehensive literature review. Objective: To discuss and summarize the current peer-reviewed literature related to the management of patients with cervical radiculopathy. Background: Cervical radiculopathy is a lesion of the cervical spinal nerve root with a reported prevalence of 3.3 cases per 1000 people; peak annual incidence is 2.1 cases per 1000 and occurs in the fourth and fifth decades of life. Nerve root injury has the potential to produce significant functional limitations and disability. Methods and Measures: A search of the MEDLINE, CINAHL, and Web of Science databases for the periods 1966, 1982, and 1996, respectively, to December 1999 was conducted using selected keywords and MeSH headings. The bibliographies of all retrieved articles were searched and pertinent articles were obtained. The Cochrane Database of Systematic Reviews was also searched. Literature related to the diagnosis, prognosis, and treatment of cervical radiculopathy were thoroughly reviewed and summarized using a critical appraisal approach. Results: Although cervical radiculopathy remains largely a clinical diagnosis, the true diagnostic accuracy of the clinical examination for cervical radiculopathy is unknown. Imaging and electrophysiologic tests are capable of detecting clinically significant problems in many patients and each modality has inherent strengths and weaknesses; technical as well as practical factors affect the choice of procedure. The natural course of cervical radiculopathy appears to be generally favorable but no prognostic or risk factors have been firmly established and the efficacy of various nonoperative treatments for the condition is unknown. Conclusion: A clear definition of terms and further research are required to establish definitive diagnostic criteria and effective treatment for the management of patients with cervical radiculopathy.
J Orthop Sports Phys Ther. 2000;30(12):728-744.
Key Words: cervical radiculopathy, diagnosis, treatment
View Abstract
View Full Article
Resident's Case Problem
Sara R. Piva, Richard E. Erhard, Majid Al-Hugail
Cervical radiculopathy (CR) is a problem that is frequently encountered by physical therapists. The incidence of CR in the fifth decade of life is 2.03%, approximately 3 times more prevalent than in other age groups. Radiculopathy is defined as any diseased condition of spinal nerve roots. Cervical radiculopathy, or disease to the nerve roots in the cervical spine, is manifested primarily by unilateral motor and sensory symptoms into the upper limb, muscle weakness, sensory alteration, and reflex hypoactivity. Generally, onset of CR is insidious and the most common causes are cervical disc lesions and osteophytic encroachment, which results in nerve root or spinal nerve impingement or inflammation. The purpose of this resident's case problem is to demonstrate the dynamics of the diagnostic process in determining the appropriate treatment for a patient with CR. Treatment selection and progression will use the treatment algorithm proposed by Erhard, combined with the information from history, physical examination findings, and the patient's response to treatment interventions during the course of rehabilitation.
J Orthop Sports Phys Ther. 2000;30(12):745-754.
Key words: cervical spine, nerve roots, rehabilitation
View Abstract
View Full Article
Clinical Commentary
Diane M. Wrisley, Patrick J. Sparto, Susan L. Whitney, Joseph M. Furman
The diagnosis of cervicogenic dizziness is characterized by dizziness and dysequilibrium that is associated with neck pain in patients with cervical pathology. The diagnosis and treatment of an individual presenting with cervical spine dysfunction and associated dizziness complaints can be a challenging experience to orthopaedic and vestibular rehabilitation specialists. The purpose of this article is to review the incidence and prevalence, historical background, and proposed pathophysiology underlying cervicogenic dizziness. In addition, we have outlined the diagnostic criteria, evaluation, and treatment of dizziness attributed to disorders of the cervical spine. The diagnosis of cervicogenic dizziness is dependent upon correlating symptoms of imbalance and dizziness with neck pain and excluding other vestibular disorders based on history, examination, and vestibular function tests. When diagnosed correctly, cervicogenic dizziness can be successfully treated using a combination of manual therapy and vestibular rehabilitation. We present 2 cases of patients diagnosed with cervicogenic dizziness as an illustration of the clinical decision making process in regard to this diagnosis.
J Orthop Sports Phys Ther. 2000;30(12):755-766.
Key Words: cervical vertigo, dysequilibrium, whiplash
View Abstract
View Full Article
Index
This index includes all authors and co-authors of manuscripts published in the Journal during 2000.
J Orthop Sports Phys Ther. 2000;30(12):788-811.
View Abstract
View Full Article
Index
Index by subject of all manuscripts published by the Journal during 2000.
J Orthop Sports Phys Ther. 2000;30(12):812-821.
View Abstract
View Full Article