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Degenerative cervical spine disease

Last reviewed: 20 Aug 2025
Last updated: 19 Sep 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • spontaneous onset of neck pain
  • cervical muscle pain and spasm
  • headaches or occipital pain
  • weakness or numbness
  • presence of radiating shoulder and upper extremity pain
  • reflex changes
  • proximal arm weakness
  • distal hand weakness
  • gait ataxia
Detalhes completos

Outros fatores diagnósticos

  • cervical muscle spasm
  • decreased cervical range of motion
  • sensory changes
Detalhes completos

Fatores de risco

  • age >50 years
  • head or neck trauma
  • previous cervical spine surgery
  • genetic predisposition
  • smoking
  • participation in contact sports
  • occupation
  • heavy load bearing
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • cervical MRI
  • cervical x-ray
Detalhes completos

Tests to avoid

  • dermatomal somatosensory evoked potentials (SEPs)
Detalhes completos

Investigações a serem consideradas

  • cervical CT scan
  • cervical CT myelogram
  • cervical/upper extremity electrodiagnostic testing
  • cervical nerve root block
Detalhes completos

Algoritmo de tratamento

AGUDA

axial neck pain

cervical spondylotic radiculopathy (CSR)

degenerative cervical myelopathy (DCM)

Colaboradores

Autores

Dennis A. Turner, MA, MD
Dennis A. Turner

Professor

Neurosurgery, Neurobiology, and Biomedical Engineering

Duke University Medical Center

Durham

NC

Declarações

DAT is an author of a reference cited in this topic.

Revisores

Richard G. Chang, MD, MPH, FAAPMR

Associate Program Director

Sports Fellowship

Assistant Professor

Icahn School of Medicine

Mount Sinai

NY

Declarações

RGC is a member of the AAPM&R Health Policy & Legislative Committee, and receives reimbursement for travel to in person once a year Capitol Hill meeting and annual AMA State Advocacy Summit conference.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Bono CM, Ghiselli G, Gilbert TJ, et al; North American Spine Society. An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J. 2011 Jan;11(1):64-72. Resumo

Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Guidelines for the surgical management of cervical degenerative disease. 2009 [internet publication].Texto completo

American College of Radiology. ACR appropriateness criteria: cervical neck pain or cervical radiculopathy. 2024 [internet publication].Texto completo

Nikolaidis I, Fouyas IP, Sandercock PA, et al. Surgery for cervical radiculopathy or myelopathy. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001466.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Degenerative cervical spine disease images
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  • Diretrizes

    • ACR appropriateness criteria: cervical pain or cervical radiculopathy
    • A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression
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