Inciting Events Associated with Cervical Radiculopathy.

BACKGROUND: Cervical radiculopathy (CR) is a clinical diagnosis defined as a combination of neck, shoulder and arm pain, often accompanied by sensory and motor symptoms. CR is often caused by degenerative spine pathology associated with impingement of a cervical nerve root, and this pathology can be visualized using MRI or CT scan. Factors that are associated with the onset of CR have not been explored.

OBJECTIVE: To investigate the types and frequencies of patient-reported inciting events associated with CR in patients with imaged confirmed pathologies that correlate with symptoms.

DESIGN: Prospective observational case series SETTING: Two spine physiatry and 3 orthopedic spine surgery practices.

PATIENTS: One-hundred-twenty-two patients with symptoms suggestive of CR were recruited. Of these, 107 patients had MRI or CT evidence of cervical disc herniation or foraminal stenosis that correlated with symptoms and matched our inclusion criteria.

METHODS: We categorized patient-reported inciting events associated with onset of their CR into six categories reflecting increasing severity of inciting event, and recorded their clinical characteristics, physical examination findings, pain intensity and disability. We analyzed the characteristics of patients based on subgroups of inciting events.

RESULTS: Two-thirds of patients reported that they either awoke with symptoms or symptoms began without memorable event, and one third of patients reported inciting physical activity or trauma associated with the onset of CR. Clinical characteristics of CR were not influenced by categories of inciting events.

CONCLUSION: A majority of CR with correlating spine pathology were found to to have onset without specific inciting events. Furthermore, physical inciting events did not influence the severity of clinical manifestation of CR.

LEVEL OF EVIDENCE: IV This article is protected by copyright. All rights reserved.