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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Druckformat: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v13.i4.20
18 pages

An Evidence-Based Algorithmic Approach to Cervical Spinal Disorders

Curtis W. Slipman
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
David W. Chow
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
Zacharia Isaac
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
Mark Ellen
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
David A. Lenrow
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
Larry Chou
Penn Spine Center, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia
Edward J. Vresilovic, Jr.
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

ABSTRAKT

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.