Spine Focus--Cervical Spine

Steven R. Garfin
Focus Articles

Epidemiology, Physical Examination, and Neurodiagnostics

Jiri Dvorák

The overall frequency of troublesome neck pain is estimated to be approximately 34%. It could be that the structural transformation of the intervertebral disc, the uncovertebral processes and the zygapophyseal joints, is a process accompanied by disturbed function, ultimately inducing pain. Electromyography is the oldest method to diagnose nerve root compression syndromes. For cervical myelopathy as routine examination, the sensory-evoked potentials as well as motor-evoked potentials are recommended.

Summary

Jiri Dvorák

Surgery in the Degenerative Cervical Spine

Dieter Grob

The failure of nonoperative treatment of degenerative cervical spine disorders often indicates surgery. In selected cases, decompression and stabilization provides excellent results in conditions with radicular symptoms. Axial neck pain presents a rare indication for surgical procedure.

Summary

Dieter Grob

Cervical Spine Models for Biomechanical Research

Manohar M. Panjabi

Biomechanical models of the cervical spine have many uses: to assist in understanding spinal function, to evaluate spinal devices, and to study effects of injury. Models are of four types: physical, in vitro, in vivo, and computer. Each model type has specific uses, advantages, and disadvantages.

Summary

Manohar M. Panjabi

Imaging of the Cervical Spine

Jay A. Kaiser and Betsy A. Holland

Multiplanar spiral computed tomography and high resolution magnetic resonance imaging, when appropriately chosen and performed, precisely demonstrate cervical spine anatomy and pathologic conditions. In this review article proper imaging techniques and applications are described in a variety of clinical settings.

Summary

Jay A. Kaiser

Cervical Spine Trauma

Howard S. An

The updated literature on cervical spine trauma is reviewed. Early assessment of clinical symptoms, imaging studies including radiographs, computed tomographic and magnetic resonance scans, and treatment options are discussed, along with a review of current spinal fixation devices.

A Review of the Pathophysiology of Cervical Spondylotic Myelopathy With Insights for Potential Novel Mechanisms Drawn From Traumatic Spinal Cord Injury

Michael G. Fehlings and Ghassan Skaf

Static and mechanical factors and ischemia are critical in the development of cervical spondylotic myelopathy. Several mechanisms of traumatic spinal cord injury including free radical- and cation-mediated cell injury, glutamatergic toxicity, and apoptosis may also be of relevance in the pathophysiology.

Summary

Howard S. An and Michael G. Fehlings

Postlaminectomy Kyphosis

Todd J. Albert and Alexander Vacarro

The work-up for surgical treatment of postlaminectomy kyphosis is reviewed. The entity represents a triad of neural compression, cervical instability, and sagittal deformity. Attention to all three components is necessary in the treatment of this difficult condition.

Summary

Todd J. Albert

Nonoperative Treatment of Neck and Arm Pain

Susan J. Dreyer and Scott D. Boden

Treatments for neck and arm pain were reviewed in the literature from 1966 to present, concentrating on the literature from 1993 through January 1998. The efficacy of various treatments and the pathologic lesions of neck pain resulting from soft tissue injury are summarized.

Inflammatory Disorders of the Cervical Spine

Mitchell F. Reiter and Scott D. Boden

The diagnosis and treatment of inflammatory disorders that affect the cervical spine are reviewed, including rheumatoid arthritis and ankylosing spondylitis.

p. 2766
Summary

Scott D. Boden

p. 2767 Primary Bone and Metastatic Tumors of the Cervical Spine

William A. Abdu and Lt. Matthew Provencher

Cervical spine tumors are rare occurrences. A literature review of the epidemiology and current diagnostic and treatment efforts are presented.

p. 2777 Summary