Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .
Reliability of Magnetic Resonance Imaging in Predicting Disc Material Posterior to the Posterior Longitudinal Ligament in the Cervical Spine: A Prospective Study
Study Design . This was a prospect i ve study to evaluate the accuracy of magnetic resonance imaging in predicting the presence of disc material posterior to the posterior longitudinal ligament ( PLL ) , compared with the accuracy of intraoperative visual and tactile examination of the PLL . Objectives . To determine the accuracy of magnetic resonance imaging in predicting the presence of disc material posterior to the PLL . Summary of Background Data . Whether removal of the disc to the PLL is sufficient when performing an anterior cervical discectomy and fusion or it is necessary to explore the spinal canal by taking down the PLL is controversial . Methods . Fifty‐four cervical levels were examined by magnetic resonance imaging before surgery to determine whether there was disc material posterior to the PLL . During surgery , the PLL was examined and probed for disruption . The ligament was taken down , and free fragments were identified and removed . Results . Of 54 levels , 12 were correctly identified by magnetic resonance imaging as having disc material posterior to the PLL , and 26 were correctly identified as not having disc material posterior to the PLL . Surgery confirmed that at 26 levels there was disc material posterior to the PLL . Of these 26 , 23 ( 88.5 % ) had visual or palpable disruption of the PLL .  Magnetic resonance imaging failed to predict disc material posterior to the PLL in 14 of the cases in which its presence was confirmed during surgery . Magnetic resonance imaging had 46.2 % sensitivity and 92.9 % specificity rates . Conclusions . Because of low sensitivity , magnetic resonance imaging should be used cautiously for predicting free disc material posterior to the PLL . Visual or palpable examination of the PLL during surgery is more accurate for this prediction
Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .