Alleviating cervical radiculopathy by manipulative correction of reversed cervical lordosis: 4 years follow-up

Abstract

Cervical radiculopathy is a neurologic condition caused by nerve root compression in the cervical spine, resulting in pain, numbness, sensory or motor dysfunction in the upper extremities. We present the case of a 57-year-old woman working as an insurance agent who suffered from chronic neck pain and numbness in the left arm for six months. Cervical radiographs revealed a reverse in natural lordotic curve. The patient was diagnosed with left C6 radiculopathy due to cervical spondylosis. Since cervical traction, rehabilitative exercise, acupuncture, and pain medicines previously failed to provide a long-lasting relief of symptoms, the patient sought chiropractic care. She was treated with spinal manipulation in combination with intermittent motorized cervical traction for three months. As a result of care, the patient experienced complete relief of symptoms, full cervical mobility, and high WHO Quality of Life score. A restoration of cervical lordosis was demonstrated on the 4-year follow-up radiograph.

Keywords: Cervical lordosis; cervical radiculopathy; chiropractic manipulation.

Figure 1

Sagittal cervical radiographs. (a) At initial assessment, posterior vertebral line (yellow line) depicted a reverse in cervical lordosis. C_2-7 Cobb angle minus 6°, narrowed interspaces from C4/C5 through C7/T1, and anterior osteophytic lipping of lower vertebrae were noted. (b) 4 years follow-up, the cervical curvature improved as compared with initial radiograph. The mean C2-C7 angle in asymptomatic women is 9.11° ± 10.4°

Figure 2

Oblique radiographs of the cervical spine. Oblique imaging at initial assessment revealed foraminal stenosis at left C5/6 and C6/7 segments (white arrows), evidence of cervical spondylosis and interspace narrowing at C4/C5 through C7/T1 levels