Evaluation of Cervical Conditions: Comprehensive Guide for Diagnosis and Treatment

Symptoms Suggestive of Cervical Pathology

Common complaints include:

• Neck pain or stiffness
• Headaches (especially occipital)
• Numbness or tingling in the arms
• Weakness in arms or legs
• Gait disturbances
• Balance issues
• Difficulty swallowing or speaking
• Vision disturbances
• Fatigue or brain fog (in cases related to ME/CFS)

These symptoms require careful correlation with imaging and clinical examination.

“A small percentage of patients diagnosed with Myalgic Encephalomyelitis (ME/CFS) have also been found to suffer from Craniocervical Instability and/or Tethered Cord. Treating these conditions can improve ME/CFS symptoms.”

Diagnostic Evaluation: From Examination to Imaging

Clinical Examination

Includes assessment of:

• Cervical range of motion
• Neurological deficits (sensory, motor, reflexes)
• Spurling’s test for radiculopathy
• Hoffman’s and Babinski signs for myelopathy
• Lhermitte’s sign

Imaging

Advanced imaging is essential. At our center in Barcelona:

• Upright CBCT: Allows evaluation in weight-bearing position
• Prone lumbar MRI: For tethered cord
• 3T MRV without contrast: For vascular structures

“We are proud to provide state-of-the-art imaging in an accessible and comfortable environment, including dynamic upright CBCT and 3T MRV.”

When patients visit us, we ensure all diagnostics are done in a single, efficient trip:

“Patients can combine imaging and an in-person consultation and evaluation with Dr. Gilete all in one visit.”

Differential Diagnosis: Why Expertise Matters

Many other pathologies can mimic each other. Accurate diagnosis avoids unnecessary surgery or under-treatment. Differentials include:

• Multiple sclerosis
• Lyme disease
• Chiari malformation
• Functional disorders
• Autoimmune diseases

Our integrative model includes evaluation of immunological and inflammatory factors when necessary:

“We evaluate not only the structural component of the cervical spine but also immunological and inflammatory markers when necessary.”

Treatment Options

Treatment is always individualized and escalated progressively:

• Conservative management: Physical therapy, bracing, neuromodulation
• Regenerative medicine: In selected cases
• Surgical treatment: When instability, nerve or spinal cord compression is confirmed

Dr. Gilete has over 25 years of experience in neurosurgical spine procedures including:

• Occipitocervical fusion
• Atlantoaxial fusion
• Cervical discectomy and fusion (ACDF)
• Cervical disc replacement (ADR)

“With over 25 years of experience within the neurosurgical field, Dr. Gilete performs a variety of surgical procedures… from craniocervical fusion… to simpler procedures like artificial disc replacement.”

When Should You See a Specialist?

If you experience persistent or worsening symptoms—especially red flags—or if you’ve been misdiagnosed previously, a specialist opinion is crucial.

“Dr. Gilete is one of only a very few neurosurgeons in the world experienced in diagnosing Craniocervical Instability (CCI) and Atlantoaxial Instability (AAI) in a neglected and often misunderstood population of patients.”

Request an evaluation today:

Request an evaluation with Dr. Gilete

About Cervical Condition Evaluation

What imaging is best to evaluate cervical spine conditions?

 Upright CBCT is considered superior for detecting instabilities, especially in conditions like CCI and AAI.

Can CCI or AAI cause brain fog and fatigue?

Yes. Especially in EDS or ME/CFS patients, CCI and AAI can lead to autonomic dysfunction, fatigue, and cognitive symptoms.

How is cervical myelopathy diagnosed?

Through clinical exam and imaging. MRI is essential to visualize spinal cord compression.

Do all cervical spine disorders require surgery?

No. Conservative approaches are often effective. Surgery is reserved for confirmed instability or significant nerve of spinal cord compression.

Can I get a remote consultation?

Yes, you can submit your imaging for review and receive an evaluation remotely by Dr. Gilete.

Conclusion

Cervical spine conditions can be complex and often misunderstood, especially in patients with connective tissue disorders or overlapping neurological symptoms. An accurate evaluation—combining clinical examination, advanced imaging, and expertise—is essential for determining the right treatment path.

At DrGilete.com, we are committed to offering world-class care, integrating state-of-the-art diagnostics with over 25 years of surgical experience and a deep understanding of conditions like CCI, AAI, and tethered cord. Whether through conservative management or specialized surgery, our mission is to help you regain stability, function, and quality of life.

If you’re experiencing unresolved cervical symptoms, especially in the context of EDS or ME/CFS, we invite you to request an evaluation and take the first step toward clarity and care.