Abstract

Objectives: In this study, we aimed to identify the course of radiculopathy and long-term functional outcomes in nonsurgically treated patients with myotomal muscle weakness caused by cervical disk herniation.

Patients and Methods: Twenty-three patients (15 males, 8 females; mean age 40.7±7.3 years; range 27 to 55 years) were included in the study. Patients were treated with specific physical therapy and rehabilitation programs. Clinical and electrophysiological evaluation were done at the beginning, every four months within the first year, and every year after two years. All patients completed 24 months, and 19 patients completed 36 months of follow-up.

Results: In 12 (52%) patients, needle electromyography (EMG) findings returned to normal at the second EMG examination. Only four (21%) patients had abnormal EMG findings at the end of the study period. In 13 (56%) patients, muscle strength became normal within four months, and it became normal in 17 (74%) patients within the first year. Progressive muscle weakness was not observed in any patient during the study. At the end of the study, excellent or good functional outcome were obtained in 15 (79%) patients.

Conclusion: Myotomal muscle weakness resulting from cervical disk herniation is usually caused by a neuropraxic lesion at the root level. Patients with axonal root injury also have high potential for recovery, due to multilevel innervation of upper extremity muscles.