While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
Preying on the Elderly?
While the number of spine surgeries has been on the increase, this is especially true for those 65 years and older. Consider the trend for low back surgery between 1979 and 1992:
Number of Low Back Surgeries per 100,000
| 1979 | 1992 | |
| Adults Under 65 | 113 | 152 |
| Adults 65 +Over | 51 | 188 |
SOURCE: Ciol MA, Deyo RA, Howell E, Kreif S. An assessment of surgery for spinal stenosis: the trends, geographic variations, complications, and reoperations. J Am Geriatr Soc 44:285-290, 1996.