Cervical Radiculopathy Treatment New York City| Dr. Zeeshan Sardar

Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director, Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY

Cervical radiculopathy — commonly called a “pinched nerve in the neck” — occurs when a nerve root exiting the cervical spine is compressed or irritated, producing pain, numbness, tingling, or weakness that radiates into the shoulder, arm, or hand. While the symptoms can be severe and frightening, most patients with cervical radiculopathy improve with non-surgical treatment. For those who do not, surgical decompression is highly effective.

WHAT CAUSES CERVICAL RADICULOPATHY?

  • Herniated cervical disc — disc material that has ruptured and is pressing directly on the nerve root; most common in younger patients, often with acute severe arm pain
  • Bone spurs (osteophytes) — arthritic bony overgrowth that narrows the foramen over time; more common in older patients with gradual onset
  • Foraminal stenosis — narrowing of the opening through which the nerve exits, from a combination of disc height loss, facet arthritis, and ligament thickening

WHICH ARM IS AFFECTED?

  • C5 root — shoulder pain and deltoid weakness
  • C6 root — pain and numbness into the thumb and index finger, bicep weakness
  • C7 root — the most commonly affected root; pain and numbness into the middle finger, tricep weakness
  • C8 root — pain and numbness into the ring and little finger, grip weakness

DIAGNOSIS

Cervical radiculopathy is diagnosed by combining the clinical history, physical examination, and imaging. MRI is the primary diagnostic study. CT or CT myelography is used when MRI is not possible or when bony detail is needed. Electrodiagnostic studies (EMG/nerve conduction) can help confirm the diagnosis and exclude peripheral nerve conditions like carpal tunnel syndrome.

NON-SURGICAL TREATMENT

  • Physical therapy — cervical stabilization exercises, posture training, traction; the most important non-surgical intervention
  • Anti-inflammatory medications — NSAIDs and oral steroids for acute pain episodes
  • Cervical epidural steroid injections — can provide meaningful relief of acute radicular pain and facilitate participation in physical therapy
  • Activity modification — avoiding positions or activities that exacerbate nerve compression

WHEN IS SURGERY INDICATED?

  • Conservative treatment has failed after 6–12 weeks of appropriate management
  • Progressive neurological deficit — worsening weakness or expanding numbness
  • Severe, intractable pain significantly impairing quality of life

SURGICAL OPTIONS

  • ACDF — removes the disc and bone spur, decompresses the nerve root, fuses the level; excellent outcomes for radiculopathy
  • Cervical disc replacement — for appropriately selected patients without kyphosis or significant facet arthritis; preserves motion while achieving equivalent decompression
  • Posterior cervical foraminotomy — a minimally invasive procedure that widens the foramen from behind without fusion; appropriate for soft disc herniations causing foraminal compression

FREQUENTLY ASKED QUESTIONS

Will my arm pain go away without surgery?

Most patients with cervical radiculopathy improve with conservative treatment alone, including physical therapy, medication, and sometimes injections, especially when there’s no progressive weakness.

How urgent is this?

Pain alone, even when severe, is rarely a surgical emergency. Progressive weakness or new loss of function is a more urgent signal and should be evaluated promptly.

Is an epidural steroid injection the same as surgery?

No. An epidural steroid injection is a non-surgical treatment that delivers anti-inflammatory medication around the irritated nerve, often providing temporary but meaningful relief without an operation.

Which surgery is right for me?

This depends on your specific anatomy, the location of compression, and your alignment. ACDF, disc replacement, and posterior foraminotomy are all options, and the right one is determined after a detailed review of your imaging.

Can cervical radiculopathy come back after surgery?

Recurrence at the same level is uncommon after adequate decompression. New symptoms at a different level over time are possible, particularly after fusion, due to adjacent segment changes.

WHY CHOOSE DR. SARDAR

Dr. Sardar evaluates each patient with cervical radiculopathy individually and offers the full range of treatment options. He is equally expert in ACDF, cervical disc replacement, and posterior foraminotomy, and recommends the procedure best suited to each patient’s anatomy and goals.

This page is for educational purposes only and does not constitute individualized medical advice.

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