Cervical spinal disease

Degenerative cervical spinal disease refers to neck pain, myelopathy, and/or radiculopathy. It is a common problem with increased prevalence above the age of 55 years. Understanding the natural history and pathophysiology is crucial in selecting patients for surgery. The degenerative pathological processes that can occur in the cervical spine include degenerative disc disease, degenerative cervical myelopathy, ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF). There are also systemic diseases affecting the cervical spine and these include rheumatoid disease, sero-negative spondyloarthropathies and diffuse idiopathic skeletal hyperostosis (DISH). This section describes the pathology of cervical spinal disease, the clinical management, surgical approaches, and controversies in the field.