Orthopedics-Online

Therapy of cervicobrachialgia

therapy

For symptomatic therapy of a Cervicobrachialgia very different therapeutic approaches are suitable. Symptomatic therapy is one of symptoms of disease (Symptoms) oriented therapy. Real causal therapy, like removing one Herniated disc of the cervical spine does not take place initially.

storage

A neck tie can provide beneficial relief in the acute phase of the disease Cervical spine can be achieved.

physical therapy

The aim of physiotherapy in acute cervicobrachialgia is to calm the mechanically irritated nerve root. For this purpose, special physiotherapy exercise treatments are carried out. With traction, a targeted body pull leads to an expansion of the intervertebral holes (Exit of the nerve roots) and to one Relaxation of the Musculature and vertebral joints. The pull can be done by hand or by special equipment, such as the sling table (Lumbar spine) and the Glisson's loop (cervical spine).

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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Further forms of therapy for cervicobrachialgia

Electrotherapy

The use of therapeutically effective forms of current (electrotherapy, electrostimulation) belongs to the field of physical therapy and is issued with the Medicines Ordinance for Physiotherapy. Different types of current have anti-inflammatory and analgesic effects.

Medication

Classic anti-inflammatory and pain-relieving drugs are non-steroidal anti-inflammatory drugs (NSAIDs) and cortisone. The application in tablet form or as a medicament for injection is possible. The main goal is to reduce pain through anti-inflammatory measures at the nerve root.

Pregabalin (Lyric ®) can also be used as an adjunct therapy for chronic cervicobrachialgia. Lyrica ® has a pain-relieving effect on neuropathic pain (nerve pain) of various kinds.

Local infiltrations

The most effective therapy for treating cervicobrachialgia is targeted infiltration of the affected nerve roots. This form of syringe therapy is also known as periradicular therapy (PRT). In order to apply infiltration precisely to the nerve root, an imaging procedure is necessary. The imaging support provided by computed tomography (CT) is particularly suitable for this. A mixture of a local anesthetic and cortisone is usually used as the injection content.

Infiltrations close to the spinal cord (Epidural Infiltration) used. In contrast to the epidural infiltration of the lumbar spine, no local anesthetic is injected, but a mixture of physiological saline solution and cortisone. The effect is very good.

Operation for cervicobrachialgia

The operation

Is cervicobrachialgia due to the severity of the underlying condition, e.g. Due to a very large herniated disc, which cannot be treated conservatively enough, surgical therapeutic measures are used by removing the herniated disc (Disc prosthesis, spinal fusion, endoscopic discectomy) and / or the nerve exit holes are enlarged (decompression, foraminotomy).

Before any surgical measure to treat the Cervicobrachialgia in question, the conservative measures should be exhausted.

Surgery is performed if there is severe nerve failure and if the symptoms have not gone away within a few months. In terms of freedom from pain, an operation is sometimes disappointing for the patient, as it is often only temporary.
The operation is performed by a neurosurgeon. During the operation, the surgeon frees the nerve from the tissue that is causing the discomfort. Due to the different possibilities for the development of a cervicobrachial ligament, these can be different types of tissue, such as the part of a herniated intervertebral disc or bone outgrowths.

Three different techniques are used in the operation of a cervicobrachialgia:

The most recent method uses a artificial disc used. Compared to the other two methods, this method has the advantage that it does not restrict the mobility of the cervical spine.
Another surgical procedure called the Microdisectomy Can be used when part of the disc is damaged and needs to be removed. However, this is only possible if the intervertebral disc has not already degenerated / previously damaged. If the operation can create instability between two vertebral bodies, it becomes a
operational connection which aspired. To do this, the surgeon takes a bone chip from the patient's iliac crest, which is inserted between the two cervical vertebrae. After two to three months, the bone is firmly integrated into its new environment and the headrest that was previously worn can be removed. This technique causes the cervical spine to lose some of its mobility.

In most patients, a reduction in strength and sensory disturbance caused by cervicobrachialgia regress after the operation, as do pain, which, however, often recurs in the further course.