Back pain is a common symptom that can be the harbinger of serious disease, particularly in elderly
patients. Separation of serious pathologies such as malignancy, infection, and cauda equina syndrome
from benign axial back pain is a challenge. The red flags have clinical use for assisting in obtaining key
features in the history and examination that may relate to sinister pathology. Knowing what and when
to refer to a spinal specialist such as an orthopaedic surgeon or neurosurgeon is important. Cervical
radiculopathy, myelopathy, and scoliosis may require specialist skills for discectomy, decompression, and
reconstruction. This article deals with the assessment and treatment of cervical myelopathy and scoliosis.