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, the beginning of one of the twelve pairs leaving the central nervous system from the brain stem or the highest levels of the spinal cord;
  • A spinal nerve root, the beginning of one of the thirty-one pairs leaving the central nervous system from the spinal cord. Each spinal nerve root consists of the union of a sensory dorsal root and a motor ventral root.

Nerve roots

Nerve roots (radix nervi SpinaliS), commonly referred to sometimes as "nerve roots" - bundles of nerve fibers extending from the spinal cord as the thread root and forming the combined spinal nerve trunk. At the height of each intervertebral space of the spinal roots go four - two roots ventral and two dorsal roots, one pair of right and left side of the core. Dorsal nerve root contains sensory nerve fibers, abdominal - motor fibers.

Pain and pathologies

Damage to nerve roots can cause paresis and paralysis created by the innervated by the spinal nerve or no pain and numbness in unerwianym area. 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
   Extensive irritation in areas within arm Head'a
   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)

C5 radiculopathy

The pain is localized to the side of the radial arm and the arm until the thumb and index finger. Pronation movement is weakened limbs and superficial sense. Sometimes observed detachment of the blade.

C6 radiculopathy

The pain radiates middle dorsal arm and forearm to the middle three fingers. Is weakened triceps arm. The painful area is also observed superficial hypoaesthesia.

C7 radiculopathy

Pain and sensory disturbances of superficial localized to the ulnar side of the limb, up to four and five finger hand. Handshake is weakened and bend the fingers, sometimes there is a small hand muscles atrophy.

Treatment Treatment should be initiated as early as possible, before any increase in muscle tone, which further intensifies the pain. In the first place it is recommended to manipulation and traction to decompress a compressed roots. Sometimes, radiculopathy is caused by herniated nucleus pulposus. Then bring good results pharmacological, physical and physiotherapy. Surgery is the last resort when conservative therapy is unsuccessful. Teams root of the lower limbs

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. Top of symptoms is rapid, caused by a sudden, firm, an uncomfortable position or hypothermia. Cold causes muscle contraction, which leads to increased previously hidden symptoms.

Symptoms

   Scoliosis
   Paraspinal muscle contracture
   The reduction of lumbar lordosis
   Positive Symptom Lasègue'a

L4 radiculopathy

There is rarely the root of all units of the lower limbs. Pain locates on the front of the thigh and shin, further radiates towards the inner ankle, sometimes the medial toe. Can be accompanied by the weakening of the superficial sensation. In addition to pain, sometimes there is a failure of the quadriceps muscle and reflex weakness rzepkowego. Characteristic is also turned positive test Lasegue'a /

L5 radiculopathy

The pain radiates to the side of the thigh and lower leg towards the back of the foot and toes 1-3. Just as in the case of roots L4 accompanied by weakness and sensory superficial muscle weakness (eg charger long toe, including the tibialis anterior, including rectifier short fingers). Often, severe paralysis, mistakenly interpreted as a peroneal nerve palsy. Characteristic is the difficulty in becoming the heels. All reflexes are preserved and correct.

S1 radiculopathy

The pain radiates to the posterior side of the thigh and lower leg to the ankle side, sometimes on up to the fourth finger and 5 Gluteal muscles are weakened, sagittal and triceps muscle calf and Achilles tendon reflex with. The patient has a problem with standing on your 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 handling, traction and poisometric 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.

Also brings relief to the patient in the position of decompress arrangement. It is helpful to the administration of anti-inflammatory drugs. In the acute and subacute main goal is to restore proper mobility by not producing pain, individually selected kinesiotherapy.

Last resort, surgery is used when other methods do not produce results.

The exception is when the patient is observed paresis - then surgery should be performed as soon as possible, as this may cause irreversible paralysis of muscles.

A new method of treating herniated disc, which 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.