Neck pain

Ian Tsang should be commended for his well-organized article on neck pain.¹ In the final paragraph, Tsang describes a case in which there was complete resolution of neurologic symptoms after spinal cord decompression. Elsewhere he states that patients whose pain arises from the cervical nerve roots or spinal cord often do not achieve complete pain relief.

In my experience with patients who have myelopathy secondary to significant cord compression, complete resolution of the myelopathy is rarely achieved, particularly if there has been significant, sustained spinal cord compression. Although the symptoms decrease in severity after decompression, spasticity and impaired intrinsic hand function often remain. I would appreciate it if Tsang would comment further on this point, as my impression in reading the article is that the prognosis for complete neurologic resolution of the symptoms of myelopathy is good.

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Patrick J. Potter
Department of Physical Medicine and Rehabilitation University of Western Ontario London, Ont.