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Condition/Disorder Synonyms

  • Herniated intervertebral disk

  • Prolapsed intervertebral disk

  • Slipped disk

  • Ruptured disk

  • Herniated nucleus pulposus

ICD-9-CM Code

  • 721.1 Cervical spondylosis with myelopathy

  • 719.48 Pain in joint involving other specified sites

  • 722.0 Displacement of cervical intervertebral disc without myelopathy

  • 722.4 Degeneration of cervical intervertebral disc

  • 722.71 Intervertebral disc disorder with myelopathy cervical region

ICD-10-CM Code

  • M47.12 Other spondylosis with myelopathy, cervical region

  • M50.00 Cervical disc disorder with myelopathy, unspecified cervical region

  • M50.30 Other cervical disc degeneration, unspecified cervical region

Preferred Practice Pattern

Key Features


  • Any disorder that affects the spinal nerve roots

  • Lateral cervical spine nerve root compression

  • Gradual or acute onset secondary to intervertebral disc or osteophyte formation in the intervertebral foramen1

Essentials of Diagnosis

  • Diagnosis made by clinical examination

  • Dermatome or myotome pattern

  • Reproduction of symptoms

General Considerations

  • Herniated disk is one cause

  • Avoid positions that increase symptoms


  • Women at greater risk than men, middle-aged to geriatric

Clinical Findings

Signs and Symptoms

  • Neck, shoulder, upper extremity pain and parasthesia often radiating to hand1

  • Pain in cervical spine worsens with cervical extension, side bending, and rotation to the involved side1

  • Diminished sensation, motor control and reflexes in the distribution of the involved nerve1

Functional Implications

  • Difficulty sustaining sitting postures secondary to neck and arm pain

  • Inability to sleep

  • Weakness with upper-extremity lifting

  • Loss of movement or feeling in upper extremity

  • Difficulty with neck movements, as with driving, secondary to pain

Possible Contributing Causes

  • Forward-head or rounded-shoulder posture due to tight pectoralis, weak periscapular, deep neck flexor muscles.

  • Prolonged extension or position of cervical side-bending towards impaired nerve

  • Facet hypertrophy

  • Size of spinal canal; can be congenital

Differential Diagnosis

  • Peripheral nerve impairment

  • Thoracic outlet syndrome

  • Shoulder pathology with radiating pain pattern

  • Spinal tumor

  • Rhomboid/trapezius spams

  • Carpal tunnel syndrome

  • Degenerative disk disease

  • Chiari malformation

Means of Confirmation or Diagnosis


  • MRI helps to visualize compressed or inflamed nerve root in diagnosis

  • X-ray/plain-film radiograph helpful if osteophyte located in intervertebral foramen

  • CT scan to show herniation compressing the spinal canal/nerves

Diagnostic Procedures

  • Electrodiagnostic/nerve conduction testing can help determine a specific impaired nerve function

Findings and Interpretation

  • Physical exam cluster to rule in cervical radiculopathy2

    • Spurling's test

    • Rotation limited to ...

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