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 arm pain
- reflex changes
- proximal arm weakness
- distal hand weakness
- gait ataxia
Outros fatores diagnósticos
- cervical muscle spasm
- decreased cervical range of motion
- sensory changes
Fatores de risco
- age >40 years
- head or neck trauma
- previous cervical spine surgery
- previous cervical myofascial strain
- genetic predisposition
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- cervical MRI
- cervical x-ray
Tests to avoid
- dermatomal somatosensory evoked potentials (SEPs)
Investigações a serem consideradas
- cervical CT scan
- cervical CT myelogram
- cervical/upper extremity electrodiagnostic testing
- cervical nerve root block
Algoritmo de tratamento
axial neck pain
cervical spondylotic radiculopathy (CSR)
degenerative cervical myelopathy (DCM)
Colaboradores
Autores
Dennis A. Turner, MA, MD

Professor
Neurosurgery and Neurobiology
Duke University Medical Center
Durham
NC
Declarações
DAT is an author of a reference cited in this topic.
Revisores
Ricardo Pietrobon, MD, PhD, MBA
Associate Professor of Surgery
Associate Professor in Anesthesiology
Associate Vice-Chair, Systems Integration
Department of Surgery
Duke University Medical Center
Durham
NC
Declarações
RP is an author of a number of references cited in this topic.
Allan I. Binder, MD
Consultant Rheumatologist
Lister Hospital
East and North Hertfordshire NHS Trust
Stevenage
UK
Declarações
AIB is an author of a number of references cited in this topic.
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
Principais artigos
Mazanec D, Reddy A. Medical management of cervical spondylosis. Neurosurgery. 2007 Jan;60(1 suppl 1):S43-50. 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].
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
North American Spine Society. Diagnosis and treatment of cervical radiculopathy from degenerative disorders. 2010 [internet publication].Texto completo
Graham N, Gross A, Goldsmith CH, et al. Mechanical traction for neck pain with or without radiculopathy. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006408.Texto completo Resumo
Gao F, Mao T, Sun W, et al. An updated meta-analysis comparing artificial cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease (CDDD). Spine (Phila Pa 1976). 2015 Dec;40(23):1816-23. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Whiplash injury (cervical myofascial strain)
- Acute disk herniation
- Metastatic malignancy
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: cervical neck 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
Mais DiretrizesFolhetos informativos para os pacientes
Back pain (lower back)
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal