Radiculopathy caused by spinal spondylosis

There are two types of radiculopathy caused by spinal degenerative processes:

• compressive neuropathy:
  • disc herniation
  • osteophyte formation
  • cause compression of the nerve roots
  • treatment is to relieve compression:
    • laminectomy
    • discectomy
      
      
• non-compressive neuropathy:
  • disc degeneration
  • is a biochemical rather than a biomechanical disorder with substance P and fibrinolysis playing a role
  • treatment consists of complete removal of the disc with fusion of the anterior or posterior (or both) vertebral bodies
    
    

There is often a mixed picture of compressive and non-compressive pathology in a degenerate spine (1).

Reference:

• Sella, E.J. Noncompressive spinal radiculitis. Orthopaedic Review. 1992, 21(7), 827-32.