Neck pain and stiffness often occurs in the aging crural spine. This is caused by arthritic type changes in the joints and degenerative discs, which can often be seen on formal x-rays. SYMPTOMS AND DIAGNOSIS: When neck pain is accompanied by shoulder, arm or hand pain and/or numbness or weakness, further workup may be needed as these symptoms suggest compression of one or more nerve roots. Evaluation requires a thorough neurologic examination and imaging using magnetic resonance imaging and/or CT scan imaging techniques. TREATMENT: Initial treatment includes immobilization with a ring, NSAID therapy, and physical therapy. Sometimes, traction rope traction is also used. Surgical treatment is often necessary if symptoms are severe and persistent despite non-surgical treatment and/or severe neurologic deficits are evident. Typically, an anterior cervical discectomy and fusion is performed and the degenerated bone spurs that grow around the disc are removed. The fusion is performed using bone from the pelvis (ilium), or from a bone bank, as well as usually a metal plate and screws to hold the vertebrae in place. If multiple levels are involved, like posterior decompression with stabilization and fusion with plates and screws, then this will be performed selectively. If there is severe spinal stenosis in the cervical spine, severe crural compression of the crural marrow itself (not just the nerve roots) can occur and can lead to loss of walking ability and/or loss of bowel and bladder function and control. This is known as crural cervical spondylosis.