Unnecessary Cervical Discectomy - A simple test to differentiate between Cervical and Shoulder Pathology: A Case Report.

Background: Diagnostic dilemma exists in differentiating between neck and shoulder pathology, as both can give a rise to shoulder and arm symptoms. In addition, the hypersensitivity of magnetic resonance imaging (MRI) scans may wrongly highlight non-clinically significant changes as potential targets for surgical intervention. The arm- squeeze test is a recognised recognized method used to help differentiate pathology arising from the shoulder or the neck. Performing this test preoperatively may prevent needless surgical intervention when diagnostic difficulties exist, even when MRI scans are not helpful. Case Presentation: We report the case of a 41-year-old male who initially presented with numbness and pins and needles in both arms. Following clinical review and an MRI scan of the cervical spine, the patient underwent an Anterior Cervical Discectomy and Fusion. Unfortunately, there was no relief of symptoms following surgery. A post- operative clinical review identified the shoulder as a potential cause of the symptoms. Conclusion: The arm- squeeze test is not popular and is not routinely used in shoulder and cervical spine examinations. However, it is recommended by National Institute for health and care excellence to help differentiate between neck and shoulder pathology, and, hence, dissemination of this information is vital.