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Last reviewed: 9 Apr 2025
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

1st investigations to order

  • cervical MRI
  • cervical x-ray

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Mazanec D, Reddy A. Medical management of cervical spondylosis. Neurosurgery. 2007 Jan;60(1 suppl 1):S43-50. Abstract

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.Full text  Abstract

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.Full text  Abstract

North American Spine Society. Diagnosis and treatment of cervical radiculopathy from degenerative disorders. 2010 [internet publication}.Full text

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. Abstract

Reference articles

A full list of sources referenced in this topic is available here.

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