Sections

Diagnosis and Management of Cervical Spondylosis

Sections Diagnosis and Management of Cervical Spondylosis
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Questions & Answers
Media Gallery
References

DDx

Diagnostic Considerations

Acromioclavicular pathology

Acute posterior cervical strain

Adhesive capsulitis

Aortic disease

Arachnoiditis

Arteriovenous malformation

Back pain

Bicipital tendonitis - Rotator cuff tears, lateral epicondylitis

Brainstem syndromes

Calcareous tendonitis

Cervical disk syndromes

Cervical lymphadenitis

Cervical rib

Congenital spinal lesion

Diskitis

Double crush syndrome

Epidural abscess

Extrinsic neoplasia (usually metastatic)

Fibrositis syndromes

Frozen shoulder syndromes

Gallbladder disease

Glenohumeral arthritis

Gout (infrequently)

Heart disease

Hyperabduction syndrome

Intervertebral osteoarthritis

Idiopathic brachial plexopathy (neuralgic amyotrophy)

Intrinsic neoplasia

Lung disease

Meningitis

Musculoligamentous injuries to the neck and shoulder

Neoplasms

Neoplasms of the shoulder

Nerve injuries

Occipital neuralgia

Osteomyelitis

Osteoarthritis of apophyseal joints

Paget disease

Pancoast tumor

Pancreatic disease

Peptic ulcer disease

Pharyngeal infections

Posttraumatic facet fracture with narrowing of the foramen

Postural disorders

Psychogenic disorders

Rheumatic fever (infrequently)

Rheumatoid arthritis

Rib-clavicle compression

Rotator cuff tears and tendonitis

Scalene muscle

Septic arthritis

Spinal cord tumors

Sternocleidomastoid tendinitis

Subacromial bursitis

Synovial cysts

Tabes dorsalis

Thoracic disk

Thoracic outlet syndrome

Tropical spastic paraparesis

Differential Diagnoses

Workup

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Media Gallery

A 48-year-old man presented with neck pain and predominantly left-sided radicular symptoms in the arm. The patient's symptoms resolved with conservative therapy. T2-weighted sagittal MRI shows ventral osteophytosis, most prominent between C4 and C7, with reduction of the ventral cerebrospinal fluid sleeve.
A 48-year-old man presented with neck pain and predominantly left-sided radicular symptoms in the arm. The patient's symptoms resolved with conservative therapy. Axial gradient echo MRI shows moderate anteroposterior narrowing of the cord space due to a ventral osteophyte at the C4 level, with bilateral narrowing of the neural foramina (more prominently on the left side).
A 48-year-old man presented with neck pain and predominantly left-sided radicular symptoms in the arm. The patient's symptoms resolved with conservative therapy. Axial CT scan at C5-6 demonstrates a large ventral osteophyte (see arrow). In addition, uncinate process hypertrophy is present bilaterally and the right neural foramen is narrowed.
T2-weighted sagittal MRI of a 59-year-old woman who presented with a spastic gait and weakness in her upper extremities showing cord compression from cervical spondylosis, which caused central spondylotic myelopathy. Note the signal changes in the cord at C4-C5, the ventral osteophytosis, buckling of the ligamentum flavum at C3-C4, and the prominent loss of disk height between C2 and C5.

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Author

Sandeep S Rana, MD Clinical Associate Professor of Neurology, Drexel University College of Medicine

Sandeep S Rana, MD is a member of the following medical societies: American Academy of Neurology, American Society of Neuroimaging, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS † Professor Emeritus of Neurology and Psychiatry, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Neuroscience Director, Department of Neurology, Crouse Irving Memorial Hospital

Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners Institute, American College of International Physicians, American College of Physicians, American Heart Association, American Stroke Association, National Association of Managed Care Physicians, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, Royal Society of Medicine

Disclosure: Nothing to disclose.

Additional Contributors

William J Nowack, MD Associate Professor, Epilepsy Center, Department of Neurology, University of Kansas Medical Center

William J Nowack, MD is a member of the following medical societies: American Academy of Neurology, Biomedical Engineering Society, American Clinical Neurophysiology Society, American Epilepsy Society, EEG and Clinical Neuroscience Society, American Medical Informatics Association

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Eli M Baron, MD and William F Young, MD to the development and writing of this article.

Sections Diagnosis and Management of Cervical Spondylosis
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Questions & Answers
Media Gallery
References

Diagnosis and Management of Cervical Spondylosis Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

Contributor Information and Disclosures

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