Cervicobrachial syndrome

Abstract

Cervikobrahijalni sindrom poznat i kao cervikalna radikulopatija je relativno čest neurološki poremećaj koji najčešće proizlazi iz degenerativnih promjena vratne kralježnice. Te promjene uključuju cervikalnu spondilozu i protruziju intervertebralnog diska. Uzrok cervikalne radikulopatije može biti i akutna hernija intervertebralnog diska uzrokovan traumom. Mehanizam nastanaka cervikobrahijalnog sindroma je kompresija i/ili iritacija korijena cervikalnog živca. Najčešći simptom radikulopatije je bol u ruci koja je obično praćena senzornim poremećajima u području dermatoma zahvaćenog živčanog korijena, dok su nešto rjeđe pridruženi i motorički poremećaji. Za dijagnozu je najčešće dovoljna anamneza i klinička slika. Slikovna dijagnostika je značajna samo kada je u korelaciji sa kliničkom slikom. Pacijenti s progresivnim neurološkim deficitom, znakovima mijelopatije, frakture ili ozljede ligamenata zahtijevaju hitnu operaciju. U odsutnosti navedenih simptoma, treba pokušati s neoperacijskim modalitetima liječenja koji uključuju: imobilizaciju i izbjegavanje aktivnosti koje pogoršavaju stanje, fizikalnu terapiju, trakciju, manipulaciju i farmakoterapiju. Većina bolesnika s cervikalnom radikulopatijom osjetit će poboljšanje bez obzira na način liječenja.Cervicobrachial syndrome, also known as cervical radiculopathy, is a relatively common neurological disorder that most often results from degenerative changes in the cervical spine. These changes include cervical spondylosis and intervertebral disc protrusion. The cause of cervical radiculopathy can also be acute herniation of the intervertebral disc caused by trauma. The mechanism of cervicobrachial syndrome is compression and/or irritation of the cervical nerve root. The most common symptom of radiculopathy is arm pain. It is usually accompanied by sensory disturbances in the dermatome area of the affected nerve root, while motor disturbances are also associated somewhat less frequently. A history and a clinical picture are usually sufficient for diagnosis. Image diagnostics is significant only when it correlates with the clinical picture. Patients with progressive neurological deficit, signs of myelopathy, fracture or ligament injury require urgent surgery. In the absence of the symptoms listed above, non-operative treatment modalities should be attempted, which include immobilization and avoidance of activities that aggravate the condition, physical therapy, traction, manipulation and pharmacotherapy. Most patients with cervical radiculopathy will experience improvement regardless of treatment method