Serious Cervical Spine Conditions

Original Editor - Rachael Lowe

Top Contributors - Rachael Lowe, Kim Jackson, Simisola Ajeyalemi, Lucinda hampton and Jess Bell  

Introduction

Clinicians must be aware of the key signs and symptoms associated with serious pathological neck conditions, continually screen for the presence of these conditions, and initiate referral to the appropriate medical practitioner when a potentially serious medical condition is suspected.

If red flags are identified in the spine, the should first consider if onward referral is appropriate. If serious enough, the therapist may refer onto Accident and Emergency such as in the case of cauda equina syndrome and fractures  Otherwise further specialist medical opinions can be gained, this may be referral onto a specialist spinal clinic.

Clinicians should identify red flags in patients with neck pain that suggest the presence serious pathology, such as infection, cancer, and cardiac involvement, and the need for medical or surgical consultation (cervical stenosis and myelopathy). Clinicians should also screen patients with neck pain for serious pathology including suspected arterial insufficiency, upper cervical ligamentous instability, and fracture.

When a patient with neck pain reports a history of trauma, the therapist needs to be particularly alert for the presence of cervical instability, spinal fracture, and the presence of or potential for spinal cord or brain stem injury. The Canadian C-Spine Rule can be used to determine when to refer for radiography in individuals following trauma where cervical spine injury is a concern.

• Cervical Arterial Dissection
• Fractures of the Cervical Spine and the Canadian C-Spine Rule
• Cervical Myelopathy
• Cervical Instability
• Cancer, Infection, and Visceral Disorders