Abstract: Background: Etiology of neck and shoulder pain may be multifactorial. When surgical intervention is indicated, the choice of whether to start with spine or shoulder surgery is an important clinical decision to make based on severity of pathologies, comorbidities, and patient preference. The literature includes with very few studies exploring the incidence or results of the surgical treatment paths followed in this clinical situation. This study compares patient-reported outcomes of patients with both cervical spine and shoulder pathology who underwent intervention for cervical, shoulder, or both pathologies.