Symptoms from cervical radiculopathy
Symptoms from lumbar radiculopathy
The diagnosis of cervical or lumbar radiculopathy is often made on clinical criterion and examination and is usually supplemented by plain x-rays and or MRI of the cervical and lumbar spine. Electrical studies including EMG or electromyography and nerve conduction studies may be used to aid in the diagnosis and differentiate the condition from other nerve problems that are caused by other conditions. Selective nerve root injections may also be used to confirm the diagnosis
Prevention of injury and repetitive strain is often effective in preventing clinical episodes of lumbar and cervical raduculopathy
Degenerative disc disease is common in aging adults, it seldom requires surgery. When flare ups of pain occur, the majority of patients respond well to non-surgical forms of treatment, and recovery occurs in about six weeks
Surgical treatment may be recommended in patients who fail to respond to initial non surgical treatment or those who develop worsening symptoms, or those who develop new more severe symptoms including weakness and disability.
Some patients who require surgery may be candidates for minimally invasive surgical treatment including minimally invasive discectomy or foramenotomy of the cervical or lumbar spine. These procedures most often are done as outpatient procedures and are performed through small tubes which minimize the muscle and ligament damage during the surgical approach and can lead to faster recovery.
Far Lateral Lumbar Disc Herniation
Lumbar disc rupture or disc herniation is a frequent cause of sciatica or leg pain which originates in the back and radiates down the leg. Symptoms can be quite severe and produce pain, weakness, numbness and difficulty walking. Most disc herniations are within the spinal canal and occur posterior, or directly behind the disc. There is a variant which is called a far lateral lumbar disc and these discs can sometimes be difficult to diagnose and also require a specialized and unique surgical approach to treat. The figure below shows a typical far lateral lumbar disc herniation at the L 4-5 interspace which caused pressure on the L3 nerve root superiorly. The surgical removal for these disc herniations requires a lateral approach rather than a midline approach and can be done through a paramedian incision and can utilize minimally invasive techniques.
Far Lateral approach using minimally invasive metrix technique
The far lateral approach utilizes a small incision made 4.5 centimeters lateral to the midline and insertion of dilators which then allow the insertion of the hollow tube metrix device which allows the surgeon to operate through the tube with specially designed instruments.