[Decision-Making for Cervical Spine Lesions: An Orthopedic Surgeon's Perspective]

In patients presenting with numbness, sensory disturbances, or motor deficits in the upper extremities, it is important to differentiate between cervical spinal cord or nerve root disorders and peripheral neuropathies. This article discusses the key points for distinguishing C8 spinal cord segment and nerve root disorders from peripheral neuropathies, particularly ulnar neuropathy and posterior interosseous nerve palsy. A comprehensive evaluation of the patterns of muscle weakness, distribution of sensory disturbances, and electrophysiological findings is essential, with careful consideration also given to the coexistence of cervical spine lesions and peripheral neuropathies. Furthermore, when the preoperative diagnosis does not correspond with the postoperative course, inflammatory or neoplastic diseases of the spinal nerves and other conditions should also be considered in the differential diagnosis, and collaboration with a neurologist is recommended.