Significance of Plain Xray Findings in Neck Pain with Relation to Cervical Radiculopathy and Myelopathy

Abstract

Introduction: Pain neck is a very common symptom and associated with cervical spondylosis prevails in all individuals. Though this is an era of advanced MRI, the old technology of plain X-ray cervical spine still gives useful information in patients with pain neck. Objective: To study the plain X-ray findings in pain neck cases of neural causes. Materials and Method: This was the cross sectional study conducted at Sri Manakula Vinayagar Medical College and Hospital over three years( January 2017-December 2019). Informed consent was obtained from all the patients included in the study. Institutional ethical committee clearance was obtained. All patients visiting the Out Patient Department (OPD) with the complaint of neck pain and back were advised to have plain X-ray cervical spine AP and Lateral views. The findings were recorded. Results Of the 148 patients, 91 patients that are 61% of the patients with the neck pain, the plain X-rays were normal, except for mild Spondylotic changes.25.6% (38 patients) had single level interbody space narrowing and in those patients common complaint was typical root pain. 4% (6 patients) had 2 or more level narrowing. 6% (8 patients) had cervical ribs of whom it was bilateral in 40% (3 patients). There were 2 cases of Klippel Feil interbody fusion (1.4%) and 3 cases had Spina Bifida (2%). Severe spondylosis with more than 3 level interspace narrowing was seen in 12 cases (8.1%) and all of them was over the age of 55. Conclusion: Not all cases with neck pain need an MRI study. Plain X-ray cervical spine that is freely available even at the periphery can give valuable findings like interbody fusion, Spondylosis, cervical rib, congenital anomalies and those cases can be managed easily without unnecessary referrals in the initial stage.