Differential Therapy of Cervical Radiculopathy and Myelopathy in Degenerative Changes of the Cervical Vertebral Column

Abstract

So-called shoulder-hand syndromes representing a radiculopathy and accompanied by pain, paresis and sensory disorders, are observed with increasing frequency as a result of degenerative restructuring processes involving the cervical intervertebral discs, associated with deformative impairment of neighbouring vertebral joints, upper plates and the ligamentous apparatus. Apparently, on account of its particular degree of mobility, the cervical vertebral column is more frequently affected, a misfortune indeed when one considers the functional significance of the nervous system it contains. In the case of monoradicular disturbance, the individual symptoms of the classical triad — namely pain, disturbance of sensation and paresis — can vary considerably in degree and, with further extension of the degeneration, a number of roots can become affected. If, as a result of protrusion, sequester perforation or the formation of marginal serrations, a space-consuming lesion having an impairing effect on the cervical canal develops, a myelopathy may be the result. Symptoms arising in the long tracts of the spinal cord, predominantly spastic pareses of the legs, which, with subsequently occurring sensory disorders, can lead to the transverse syndrome, can be seen.