Management of Cervical Radiculopathy with Positive Spurling Test

Diagnostic Confirmation

MRI without contrast is the recommended imaging modality for patients with suspected cervical radiculopathy, as it correctly identifies approximately 88% of lesions compared to 81% for CT myelography, according to the American College of Radiology 1, 2
CT scanning can be considered as an alternative when MRI is contraindicated, particularly for evaluating bony structures, though it is less sensitive for nerve root compression, as noted by the American College of Radiology 3, 2

Surgical intervention should be considered when conservative treatment fails to provide adequate relief, as recommended by the American Association of Neurological Surgeons 4, 5
Posterior laminoforaminotomy is recommended as a surgical treatment option for symptomatic cervical radiculopathy resulting from soft lateral cervical disc displacement, according to the American Association of Neurological Surgeons 4
Posterior laminoforaminotomy is also recommended for cervical spondylosis with resultant narrowing of the lateral recess, as noted by the American Association of Neurological Surgeons 4, 5, 6
Studies show good to excellent outcomes in 93-95% of patients undergoing laminoforaminotomy for cervical radiculopathy, according to the American Association of Neurological Surgeons 5, 7
Herniated cervical discs causing radiculopathy may be treated from either an anterior or posterior surgical approach, as recommended by the American Association of Neurological Surgeons 4, 5

MRI findings should be interpreted cautiously as they frequently show false-positive and false-negative results, and abnormalities are often present in asymptomatic patients, according to the American College of Radiology 1, 2
Abnormal levels on MRI do not always correspond to clinical examination findings, as noted by the American College of Radiology 2