Cervical angina.

Cervical angina, resembling true angina pectoris, but resulting from cervical spondylosis and nerve root compression, is also known as pseudoangina. This report describes 164 patients treated over a 22-year period. Patients included 103 men and 61 women, with ages ranging from 45 to 68 years and averaging 54 years of age. The duration of symptoms prior to definitive diagnosis averaged ten months and ranged from ten to 18 months. Most patients had consulted at least two cardiologists prior to diagnosis. The results of stress testing were abnormal in ten patients, but none underwent angiography. Symptoms common to all patients, in varying severity, included neck pain and stiffness, occipital headache, arm pain with sensory symptoms. Neurologic deficit was found in only three instances. The majority of patients responded satisfactorily to a standard nonsurgical regimen, employed for at least three months, involving the use of a hard collar, intermittent traction, isometric exercise, and a combination of anti-inflammatory and muscle relaxant medications. In cases where disability persisted, myelography was usually employed and when confirming nerve root compression, anterior disc excision and spine fusion were performed. Such treatment was required in only 38 cases and resulted in complete relief of complaints in all but five instances in which fusion failure required re-operation with ultimate success. Fusion usually was completed in three months, during which time the patient was required to wear a hard collar.