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Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

Institutional price:	$684.00
Issues per year:	4

2001, Volume13

74 pages

Issue price - $163.00

An Evidence-Based Algorithmic Approach to Cervical Spinal Disorders

Curtis W. Slipman, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

David W. Chow, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

Zacharia Isaac, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

Mark Ellen, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

David A. Lenrow, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

Larry Chou, M.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia

Edward J. Vresilovic, Jr., M.D., Ph.D.
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Orthopedic Disorders, Hospital of the University of Pennsylvania, Philadelphia

ABSTRACT

Cervical injection procedures are commonly used for the nonsurgical management of cervical pain with or without radicular signs. Because the majority of studies investigating the utility of cervical injection procedures have been conducted in the last decade, there has been little time to develop pathways that systematically incorporate these procedures in daily clinical management. We review the literature concerning fluoroscopically guided interventional techniques in the nonsurgical management of cervical spinal disorders such as cervical radiculopathy, cervical radicular pain, cervical facet joint syndrome, and cervical internal disc disruption syndrome. A basic tenet underpinning the use of such techniques is that an accurate diagnosis allows for specific treatment and therefore, better outcomes. We adhere to this principle leading to our use of diagnostic and therapeutic algorithms. We offer a preliminary paradigm that provides the clinician with a mechanism to systematically formulate a differential diagnosis and therapeutic plan. This process necessitates continuous revision as new information is published, thereby implying plasticity to these algorithms.