Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Condition/Disorder Synonyms ++ Herniated intervertebral diskProlapsed intervertebral diskSlipped diskRuptured diskHerniated nucleus pulposus +++ ICD-9-CM Code ++ 721.1 Cervical spondylosis with myelopathy719.48 Pain in joint involving other specified sites722.0 Displacement of cervical intervertebral disc without myelopathy722.4 Degeneration of cervical intervertebral disc722.71 Intervertebral disc disorder with myelopathy cervical region +++ ICD-10-CM Code ++ M47.12 Other spondylosis with myelopathy, cervical regionM50.00 Cervical disc disorder with myelopathy, unspecified cervical regionM50.30 Other cervical disc degeneration, unspecified cervical region +++ Preferred Practice Pattern ++ Pattern 4F: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, and Reflex Integrity Associated With Spinal Disorders1 +++ Key Features +++ Description ++ Any disorder that affects the spinal nerve rootsLateral cervical spine nerve root compressionGradual or acute onset secondary to intervertebral disc or osteophyte formation in the intervertebral foramen1 +++ Essentials of Diagnosis ++ Diagnosis made by clinical examinationDermatome or myotome patternReproduction of symptoms +++ General Considerations ++ Herniated disk is one cause Avoid positions that increase symptoms +++ Demographics ++ Women at greater risk than men, middle-aged to geriatric +++ Clinical Findings +++ Signs and Symptoms ++ Neck, shoulder, upper extremity pain and parasthesia often radiating to hand1Pain in cervical spine worsens with cervical extension, side bending, and rotation to the involved side1Diminished sensation, motor control and reflexes in the distribution of the involved nerve1 +++ Functional Implications ++ Difficulty sustaining sitting postures secondary to neck and arm painInability to sleepWeakness with upper-extremity liftingLoss of movement or feeling in upper extremityDifficulty with neck movements, as with driving, secondary to pain +++ Possible Contributing Causes ++ Forward-head or rounded-shoulder posture due to tight pectoralis, weak periscapular, deep neck flexor muscles. Prolonged extension or position of cervical side-bending towards impaired nerveFacet hypertrophySize of spinal canal; can be congenital +++ Differential Diagnosis ++ Peripheral nerve impairmentThoracic outlet syndromeShoulder pathology with radiating pain patternSpinal tumorRhomboid/trapezius spamsCarpal tunnel syndromeDegenerative disk diseaseChiari malformation +++ Means of Confirmation or Diagnosis +++ Imaging ++ MRI helps to visualize compressed or inflamed nerve root in diagnosisX-ray/plain-film radiograph helpful if osteophyte located in intervertebral foramenCT scan to show herniation compressing the spinal canal/nerves +++ Diagnostic Procedures ++ Electrodiagnostic/nerve conduction testing can help determine a specific impaired nerve function +++ Findings and ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.