Last reviewed: 23 Aug 2021
Last updated: 23 Sep 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • 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

Other diagnostic factors

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

Risk factors

  • age >40 years
  • head or neck trauma
  • previous cervical spine surgery
  • previous cervical myofascial strain
  • genetic predisposition

Diagnostic investigations

Investigations to consider

  • cervical CT scan
  • cervical CT myelogram
  • cervical/upper extremity electromyography or nerve conduction velocity
  • cervical nerve root block

Treatment algorithm

Contributors

Authors

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

Professor

Neurosurgery and Neurobiology

Duke University Medical Center

Durham

NC

Disclosures

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

Peer reviewers

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

Disclosures

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

Disclosures

AIB is an author of a number of references cited in this topic.

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