Cervical spine and radicular pain syndromes

Neck pain may affect one third of the adult population from time to time and may persist for 6 months or longer in 10% to 15% of these patients. In addition, cervical spine disease or trauma may result in injury to the spinal cord or nerve roots, through a variety of mechanisms, leading to a group of syndromes that can be broadly classified as myelopathy or radiculopathy. This review addresses recent developments in the anatomy and physiology of the normal cervical spine, common ill-defined or miscellaneous neck pain problems, and cervical injuries, with emphasis on the flexion-extension injury called “whiplash.” Other types of injuries, including fractures and fracture dislocations, also are discussed, as well as neurologic consequences of cervical disk and facet joint degenerative disease, with emphasis on cervical spondylitic myelopathy. the complications of inflammatory joint diseases such as ankylosing spondylitis and rheumatoid arthritis are not specifically addressed in this review.