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A 70 year old man was referred to us complaining about neck pain that had irradiated to the left shoulder and clavicular region over 12 months. There was no history of external trauma, or exposure to radiation, and no other manifestations were apparent initially. A prominent cervical spondylosis that mildly diminished the spinal duct diameter had been monitored with regular radiographic examination. The pain had been treated by his family physician, with an initial...