Cervical spondylosis is a syndrome characterized by degenerative changes in the cervical intervertebral disc tissue and its accessory structures, which subsequently cause compression or stimulation of adjacent nerve roots, spinal cords, or blood vessels, and the appearance of corresponding clinical symptoms. Cervical radiculopathy (CSR) is the most common type of cervical spondylosis in clinical practice, mainly manifested as sensory, motor, and reflex disorders consistent with the distribution area of spinal nerve roots. The symptoms are mainly characterized by severe neck pain and limited neck movement. The pain radiates to the shoulders, arms, forearms, and fingers, and may be accompanied by weakness in the upper limbs and numbness in the fingers. The nerve roots of C5, C6, and C7 are most commonly involved. Brachial plexus neuritis (BPN), also known as neuralgic amyotrophy (NA), is a common peripheral nerve disease that can lead to motor and sensory dysfunction of the affected limb, severely affecting patients' lives and work. The cause of BPN remains unclear. It is speculated to be caused by viruses and immune factors, and may also be related to genetic factors. BPN attacks often start with severe pain around the shoulder and deep within the clavicle, which is generally ineffective with painkillers. Three to ten days later, muscle weakness in one upper limb occurs, followed by rapid muscle atrophy, and the pain tends to ease. Early identification, active diagnosis and treatment, and rehabilitation are conducive to the patient's recovery. Because the two share similar symptoms, such as neck and shoulder pain, abnormal sensations, or reduced muscle strength, BPN is often misdiagnosed as cervical spondylosis of the nerve root type in clinical practice. Especially when cervical spondylosis and BPN coexist, it is more likely to be misdiagnosed and mistreated.

To explore the clinical characteristics, diagnostic key points, and treatment methods of patients with cervical spondylosis complicated with brachial plexus neuritis.

The data of 22 patients diagnosed with cervical spondylosis complicated with brachial plexus neuritis who visited Fuxing Hospital Affiliated to Capital Medical University and Tsinghua Changgung Hospital of Tsinghua University in Beijing from August 2016 to January 2025 were collected. Their onset characteristics, symptoms and signs, imaging (cervical MRI, brachial plexus nerve ultrasound/MRN), and neuroelectrophysiological features were summarized. Moreover, follow up on its comprehensive therapeutic effect.

Among the 22 patients, 16 were male, and 6 were female, aged 43 to 87 years, with disease courses ranging from 10 days to 7 months. All 22 patients presented with acute exacerbation of pain and movement disorders based on chronic neck discomfort, and most of them were accompanied by evident proximal muscle atrophy of the upper limbs. Electromyography confirmed neurogenic damage, mainly due to brachial plexus injury, with a pattern characterized by injury to common motor nerves such as the suprascapular, axillary, and musculocutaneous nerves. After comprehensive treatment, the pain of all patients was significantly relieved. At the 6-month follow-up, 21 patients achieved clinical cure.

Cervical spondylosis and brachial plexus neuritis can coexist. For patients with complex shoulder and arm pain, this should be considered. A detailed electrophysiological examination is key to a precise diagnosis. Comprehensive conservative treatment for such diseases is an important means to improve prognosis.