Cervical Spine Orthopedics II Practice Exam

Chemical radiculitis after disc herniation occurs when nucleus pulposus material leaks and releases substances that irritate the nerve root. The nucleus pulposus is rich in proteoglycans, which attract and retain water and, when exposed to neural tissues, promote an inflammatory environment around the nerve root. Phospholipases released from disc material break down membrane phospholipids to release arachidonic acid, leading to production of inflammatory mediators such as prostaglandins and leukotrienes that sensitize nociceptors. This combination causes chemical irritation and pain beyond simple mechanical compression. Structural components like collagen and elastin are more about disc structure, while water, electrolytes, lipids, and sugars are not the primary irritants initiators in this scenario.