The pathogenesis and clinical treatment progress of cervical spondylotic radiculopathy

Objective: This review was designed to summarize the pathogenesis, clinical manifestations and current progress in clinical treatment of cervical spondylotic radiculopathy (CSR), so as to provide clinicians with a comprehensive understanding of CSR and reference for treatment strategies. Method: A comprehensive search was conducted across multiple databases, including PubMed (https://pubmed.ncbi.nlm.nih.gov/), Embase (https://www.embase.com/search/), Web of Science (https://www.webofscience.com), Science Direct (https://www.sciencedirect.com/), the Chinese Biomedical Literature Database (https://www.sinomed.ac.cn/index.jsp), the China network (https://book.oversea.cnki.net/), Wanfang Data (https://www.wanfangdata.com.cn/), and the VIP Database (https://www.cqvip.com/). 174 articles related to CSR, encompassing basic research, clinical reports, and review articles were collected, in which, 104 articles were selected for detailed analysis. The collected studies were then classified and summarized to analyze the pathogenesis, pathophysiological processes, and diagnostic criteria of CSR. The review also aimed to explore the typical clinical manifestations of CSR, discuss its differential diagnosis, summarize current treatment methods, and evaluate the efficacy and safety of these treatments. Results: CSR is a clinical syndrome resulting from various factors, including cervical disc degeneration, osteophyte formation, ligamentous laxity in cervical joints, subluxation, and irritation or compression of cervical nerve roots. The underlying mechanisms involve both mechanical compression and chemical irritation. Current treatment options encompass Western medicine, traditional Chinese medicine (TCM), and physical therapy. Conclusions: Various therapeutic approaches for CSR include surgery, TCM, and combination therapies. Future research should prioritize investigating the molecular mechanisms underlying CSR and further elucidating the mechanisms of action of different treatment modalities to enhance the scientific foundation for clinical management of the condition.