Nerve root

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A nerve root (Latin: radix nervi) is the initial segment of a nerve leaving the central nervous system. Types include:

• A cranial nerve root is the initial or proximal segment of one of the twelve pairs of cranial nerves leaving the central nervous system from the brain stem or the highest levels of the spinal cord.
• A spinal nerve root is the initial or proximal segment of one of the thirty-one pairs of spinal nerves leaving the central nervous system from the spinal cord. Each spinal nerve is formed by the union of a sensory dorsal root and a motor ventral root, meaning that there are sixty-two dorsal/ventral root pairs, and therefore one hundred and twenty four nerve roots in total, each of which stem from a bundle of nerve rootlets (or root filaments).

Video Nerve root

Pain and pathologies

Damage to nerve roots can cause paresis and paralysis of the muscle innervated by the affected spinal nerve. It can also cause pain and numbness in the corresponding dermatome. A common cause of damage to the nerve roots are lesions in the spine, such as prolapse of the nucleus pulposus, spinal tuberculosis, cancer, inflammation, spinal tabes. Root pain syndromes, known colloquially as radiculitis, sciatica are one of the most common symptoms caused by damage to the nerve root. Radiculopathy is commonly called the "root". In addition to pain, accompanied by neurological defects. Typically, mechanical dysfunction is caused by pressure on the nerve root or shock can affect both the roots of the lower limbs and arms. Teams root of the upper limbs

The first sign of disease, sometimes before a few years, the occurrence of radicular syndrome are pain in the neck and shoulder area. Usually, the pain occurs as a consequence of a cold or hypothermia, sometimes calls it load, poor working posture or sleep, sudden movement of the head. Teams root localized mostly within the three lower cervical roots C5, C6, C7.

Symptoms

• Forced, reflexive position of the spine (the slope and a slight twist in the opposite direction has fallen Root)
• Paraspinal muscle contracture
• Reduction of cervical lordosis
• Numerous painful points on the edges of the blade
• Pain at the back of the head slope
• Pain radiating to the upper chest and shoulder area
• The positive sign of nerve root tension in the upper limbs (not always)

Maps Nerve root

Upper limb radiculopathies

C5 radiculopathy

• Pain is found along the lateral brachium of the affected side of the arm.
• C5 innervated muscle weakness may be found i.e. rhomboids, deltoid etc.

C6 radiculopathy

• Pain is found along the lateral antebrachium of the affected arm
• C6 innervated muscles are weak i.e. forearm pronator and supinators, wrist extensors etc.

C7 radiculopathy

• Pain is found along the middle finger of the affected arm
• C7 innervated muscle weakness is found i.e. wrist flexors, finger extensors etc.

Treatment

Treatment should be initiated as early as possible, before any increase in muscle tone, which further intensifies the pain. Traction is recommended to decompress a compressed roots. Radiculopathy can be caused by herniated nucleus pulposus. Surgery is the last resort when conservative therapy is unsuccessful.

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Lower limb radiculopathies

Often on a single nerve root, the cause is a herniated intervertebral disc. The first harbinger of roots is usually lumbago. The disease usually occurs with periods of remission. From the first symptoms to develop a full radicular syndrome may take several months or several years. Pain increases gradually, but it can also be sudden. Cold causes muscle contraction, which leads to increased previously hidden symptoms.

Symptoms

• Scoliosis
• Paraspinal muscle contracture
• The reduction of lumbar lordosis

L4 radiculopathy

• Pain located on the front of the thigh and shin, further radiates towards the inner ankle, sometimes the medial toe
• Occasionally, failure of the quadriceps muscle and reflex weakness

L5 radiculopathy

• Pain radiates to the side of the thigh and lower leg towards the back of the foot and toes 1-3
• All reflexes are preserved

S1 radiculopathy

• Pain radiates to the posterior side of the thigh and lower leg to the ankle side, sometimes up to the fourth toe
• Gluteal muscles are weakened
• Difficulty standing on toes

Treatment

The treatment team is dependent on the root of the abnormality and the stage of the disease.

In the acute phase, in order to unlock the nerve root is recommended to apply traction and isometric muscle relaxation. In cases where the manipulation is undesirable or impossible to carry out the infiltration may be root. In the case of the severe pain, this procedure should be carried out first.

It is helpful to the administration of anti-inflammatory drugs. In the acute setting, the main goal is to restore proper mobility by not producing pain, individually selected physiotherapy. Surgery is used when other methods do not produce results.

The exception is when paralysis is observed; in those cases, surgery should be performed as soon as possible to avoid irreversible paralysis of muscles.

A new method of treating herniated discs is the direct cause of any root is termonukleoplastic, the treatment consisting in introducing into the annulus fibrous of a special catheter tip heating. Warming up for a few minutes end to 65 °C results in the destruction of pain-sensitive nerve endings within the fibrous ring, reducing the volume of disk space and alleviate inflammation associated chronic irritation.

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References

Source of the article : Wikipedia