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Degenerative cervical spine disease

Last reviewed: 2 Oct 2024
Last updated: 23 Sep 2021

Summary

Definition

History and exam

Key diagnostic 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
Full details

Other diagnostic factors

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

Risk factors

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

Diagnostic tests

1st tests to order

  • cervical MRI
  • cervical x-ray
Full details

Tests to consider

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

Treatment algorithm

ACUTE

axial neck pain

cervical spondylotic radiculopathy (CSR)

degenerative cervical myelopathy (DCM)

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.

  • Degenerative cervical spine disease images
  • Differentials

    • Whiplash injury (cervical myofascial strain)
    • Acute disk herniation
    • Metastatic malignancy
    More Differentials
  • Guidelines

    • 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
    More Guidelines
  • Patient information

    Back pain (lower back)

    More Patient information
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