xx{ Innervation and Pain Patterns of the

In many respects the cervical spine has been like a "poor relation " of the lumbar spine. Thcre have been few cxperimenral and pathologic studies of servical pain syndromes. lnstead, concepts relating to the cervical spine have been based mainly on e.rtrapolations of dara on the lumbar spine. Because it was believed that root compression by herniated iscs was the cardinatcause of low back pain ond sciatica, it was assumcd that cervical pain and arm pain must be due to the sam € sause. Yet such extrapolations havc been made, and largely accepted, without rccognizing thar srructurally and functionally the cervical spine is quite differenr from rhe lumbar spinc. The cervical spine is designed for mobiliry, and it is not subject o the same magnitude of weighr-bearing forces and bending moments as is the rumbar spine. The cervical zygapophyscal joints are orienred in a different plane and af,e more involved in weight-bearing and less in the resistance of torsion than the lumbar zygapophyseal joints. Th1 cervical discs are more fibrous and differ biochemically from lumbar discs,r and disc hcrniation is far less frequent in rhe cervical spine than in the fumbar spine.3', Spondylosis i the most common parhologic change in the cerviccl spine. and the cervical nerve roots are most commonly affected by disc bulges or osreophyrcs of the uncovenebral region and the.zygapophyseal joints than by frank or acure disi prolapse.se. Becouse of these anatomic, funcrional and pathologic differences in the cervical spine, cervical pain syndromes hould be analyzed and inrerpreted as a s€parale entity rarher than being viewed as equivalent to lumbar syndromcs located at a more rqstral level of the vertebral column