A geriatric female smoker presents to the GP with the complaint of neck pain and radiculopathy. The worsening numbness and tingling in the arm limited her computer work and leisure time. Due to the exacerbating effects, her aerobic activities are also suspended. Physical examination reveals that the patient stands with her neck slightly flexed forward. She faces difficulty with extension past neutral and flexion; lateral rotation of 50 degrees is possible only before the onset of pain.
Weakness in the right elbow and left wrist extension was seen, along with decreased bilateral sensation in C6, C7, and C8 dermatomes. Bilaterally positive Spurling’s sign and Hoffman’s sign were seen. Initial treatment was done with physical therapy, NSAIDs, muscle relaxant, and non-narcotic pain medication, which provided short-lived and unsatisfactory relief. Lateral X-ray and sagittal MRI (above image)…
