Cervical Spine

Your cervical spine is made up of the initial seven vertebrae. It allows for a range of head movements, supports the weight of your head, and protects and covers your spinal cord.

This region of your spine may be impacted by a number of diseases, such as stenosis, degenerative bone and disk disease, arthritis, and neck pain. Many choices are present for treatment.

What is the Cervical Spine?

The seven vertebrae that make up the cervical spine, or neck area of the spine, lay on top of one another. The first two vertebrae in your cervical spine are unique in structure and role. Starting at the base of your skull, the atlas, which is also known as the first vertebra (C1), is a ring-shaped bone. The name Atlas comes with Atlas, a Greek mythological person. The atlas keeps your head vertical. The atlas may turn against your second vertebra (C2), also referred to as the axis, which allows side-to-side “no” rotation of your head.

The facet joints that connect your seven cervical vertebrae (C1 to C7) at the back of the bone let you to move your neck forward, backward, and in a twisting manner.

In addition, muscles, nerves, tendons, and ligaments surrounding your cervical spine. Intervertebral disks, also referred to as “shock-absorbing” disks, are situated in between each vertebra. The spinal cord passes through the middle of your back. Your brain, which is in charge of all bodily functions, communicates with your spinal cord through messages.

Cervical Spine Functions:

There are various purposes for your cervical spine, including;

• Maintaining head support while providing mobility

The average head weight of 10 to 13 pounds is supported by your cervical spine. Further, the ability allows you to move from side to side, lean forward or backwards, and bend your head and neck to one side (ear to shoulder; lateral flexion).

• Protecting the spinal cord.

The central vertebrae of your body include a large opening known as the vertebral foramen, through which the spinal cord’s nerves travel. This opening originates at the base of your skull and continues through the cervical, thoracic, and end between the first and second lumbar (lower back) vertebrae. Your spinal cord is protected by the protective central canal formed by the vertical arrangement of all the vertebrae in your spine.

• Supplying the vertebral arteries with a secure pathway.

Your brain receives blood supply from the vertebral arteries via tiny holes located in cervical spine vertebrae C1 through C6. In the entire spine, this is the only segment of vertebrae where arteries can pass through holes in the bone.

What additional muscles and soft tissues cover the neck?

Your Cervical Spine is attached to the following main muscles;

• Sternocleidomastoid

From behind your ear to the front of your neck, there are two muscles on either side of your neck. It is attached to both your collarbone and breast bone (sternum). This muscle helps you to lift your chin upward and rotate your head side to side.

• Trapezius

From the base of your skull, through your cervical and thoracic spine, and out to your shoulder blade, lie these two triangular muscles. They can help with raising your shoulder blade, rotating your head to the left or right, and rotating your head upward or backward.

• Levator scapula

The attachment points of this muscle are the top of your shoulder blade, or scapula, and the first four cervical vertebrae. It provides elevation of the shoulder blade, rotation of the head, and lateral head bending.

• Erector spinae

This muscle group consists of multiple muscles. These muscles support proper posture, rotation of the neck, and extension of the neck backward in the cervical spine.

• Deep cervical flexors

Deep cervical flexors are the muscles that run down the front of your cervical spine. They facilitate you to move your neck forward, which helps maintain the strength of your cervical spine.

Cervical Spinal ligaments:

Your Cervical Spine’s ligaments, which join bone to bone, help in maintaining the stability of your neck.

There are three main cervical spine ligaments;

• Anterior longitudinal ligament

A ligament that runs from the base of your skull to the cervical vertebra’s front. To prevent the neck from turning back, it stretches.

• Posterior longitudinal ligament

This ligament starts at C2 and runs the entire length of your cervical vertebrae. It extends to stop the neck from turning forward.

• Ligamentum flava

The rear of each vertebra’s internal opening, and through which your spinal cord passes, is lined with these ligaments. For the spinal cord, these ligaments offer cushioning and defense.

Cervical Spine disks:

Situated in between each vertebra, the cervical disks function as “shock absorber cushions.” There are seven cervical vertebrae in total, with one disk between every two vertebrae. Apart from providing support against strains on your neck, the disks allow easier head flexion and rotation while engaging in physical activities.

The Cervical Spine’s nerves:

In your cervical spine, eight pairs of spinal nerves leave through small spaces called foramen between each pair of vertebrae. They keep the codes C1 through C8. It gives you sensations and works the muscles in your hand, arm, shoulder, and neck.

• C1 , C2, C3 Cervical Spine nerve:

Your head and neck movements can move forward, backward, or sideways because of to the C1, C2, and C3 cervical nerves. Your head’s upper region is sensed by the C2 nerve, while the sides and back of your head are sensed by the C3 nerve.

• C4 Cervical Spine nerve:

The diaphragm, the breathing muscle located at the base of your rib cage, is controlled by cervical nerve 4, which also controls your upward shoulder mobility. Sensation is supplied to certain areas of your upper arms, shoulders, and neck by C4.

• C5 Cervical Spine nerve:

The deltoid muscles in your biceps and shoulders are under the control of cervical nerve 5. Your upper arm’s upper portion down to your elbow is felt by C5.

• C6 Cervical Spine nerve:

In addition to controlling your wrist extensor muscles, cervical nerve 6 also affects your biceps. C6 gives your hand and forearm sensitivity on the thumb side.

• C7 Cervical Spine nerve:

Cervical nerve 7 controls the muscle groups of the triceps and wrist extensor muscles. Your hand’s middle finger and the back of your arm are sensitive to C7.

• C8 Cervical Spine nerve:

The pinky side of your hand and forearm are sensed by cervical nerve 8, which also controls your hands.

Which diseases and medical conditions effect the cervical spine?

Disorders with the cervical spine and the soft tissues and nerves that surround it can lead to a number of diseases and medical conditions.

Among these are;

• Herniated Disc

The tear or leak in question is to the disks that act as a cushion between vertebrae. Moving and bending are made easy by intervertebral disks.

• Cervical radiculopathy

When a cervical nerve is compressed by the cervical vertebrae, this condition develops. You might feel pain, tingling, numbness, and weakness. You may have localized symptoms or ones that affect your entire arm, hand, and fingers. Cervical compressed nerves or pinching is another term for cervical radiation.

• Neck pain

A common sign of an extensive variety of illnesses and injuries is neck pain. Degenerative diseases (osteoarthritis, spinal stenosis, herniated disk, pinched nerve),  physical strain, mental stress, bad posture, growths (tumors, cysts, bone spurs), meningitis, rheumatoid arthritis, and cancer are among the common causes.

• Cervical spondylosis

The slow degradation of your cervical spine’s disks and joints with aging is known as cervical spondylosis, or arthritis of the neck.

• Spinal cord injury in the neck.

An injury to your cervical vertebrae is known as a cervical spinal cord injury. The majority of spinal cord injuries are caused by an unexpected, powerful explosion to the cervical vertebrae.

• Cervical stenosis

Your cervical spine’s spinal canal narrows, which causes this condition. The amount of space available for your spinal cord and the nerves that branch off of it decreases when your cervical spine has a smaller space. Your spinal cord or nerves may feel pinched, compressed, or uncomfortable due to a constricted area.

How are conditions affecting the Cervical Spine diagnosed?

Prior to beginning any treatment, your doctor will review your medical history, ask you about your medications, conduct a physical examination, order tests, and do imaging studies.

Diagnostic imaging and tests could involve;

• MRI stands for magnetic resonance imaging.

To create detailed images, this test makes use of radio waves, a computer, and a large magnet. Spinal degeneration, disk herniation, infections, tumors, and issues with your spinal cord and nerves leaving the spinal column can all be detected by this scan.

• X-rays

X-rays use a tiny amount of radiation to produce images of your soft tissues and bones. X-rays can reveal arthritis, disk issues, fractures, and issues with spinal alignment.

• Nerve conduction studies and electromyograms (EMG)

An EMG can be used to examine the function of the muscles and nerves. In the process of nerve conduction tests, the electrical signal conduction velocity of your nerve is evaluated. The location of nerve compression and ongoing nerve damage can be determined with the aid of the test results.

• Computed tomography (CT) scan

This scan creates extremely thin “slices” of the area being examined using X-rays and computers. Your spinal canal’s size, shape, contents, and surrounding bone can all be seen on a CT scan. Osteophytes, bone spurs, bone fusion, and infection-or tumor-induced breakdown of bones are among the conditions for which it verifies the diagnosis.

How is treatment for Cervical Spine conditions managed?

Treatment options for many diseases affecting the cervical spine include nonsurgical and surgical approaches. The cervical spine problem’s severity and underlying cause will determine the course of treatment.

What nonsurgical techniques are available for treating disorders of the cervical spine?

In cases where your neck pain isn’t caused by a tumor or trauma, your physician may initially recommend alternative procedures.

An example nonsurgical treatment choices include the following;

• Rest
• A gentle cervical collar. Your neck is supported and immobilized by a collar
• Physiotherapy
• Pharmaceuticals, such as acetaminophen, muscle relaxants, and anti-inflammatories like naproxen and ibuprofen.
• Injections of steroids

Which surgical procedures are available to treat Cervical Spine issues?

Common decompression surgical techniques include:

• Discectomy of the cervical spine

During this procedure, your surgeon will remove a portion of a disk to release pressure on the nearby nerve roots.

• Cervical laminectomy

Your surgeon will remove the laminate, which is a small section of the bony arches of the spinal canal, during these procedures. Just a small amount of the lamina is removed during a laminotomy. A laminectomy involves removing the entire lamina as well as any necessary thickened ligament, disk material, and bone spurs. After the lamina is removed, pressure is released by enlarging the spinal canal.

• Corpectomy of the cervical region

In order to release stress on the spinal cord, your surgeon will remove the disk and the large front portion of the vertebra, also referred to as the vertebra’s bulk. After this, in particular situations, fusion of the vertebrae—a permanent joining of two or more vertebrae may occur in order to maintain the stability of your cervical spine.

• Fusion of the cervical spine

One or more cervical vertebrae are surgically joined long-term during a procedure called cervical spinal fusion. Following surgery, the movement between the vertebrae is eliminated.

• Replacement of the cervical disk

During a cervical disc replacement procedure, the surgically removed infected cervical disk is replaced with an artificial disk. Cervical disk degeneration is the most common reason for this kind of surgery.

Summary:

The cervical spine is the section of your spinal column, or backbone, that is located in your neck. Your first seven bones are part of this structure (C1–C7). The cervical spine also contains or is surrounded by the muscles, tendons, ligaments, spinal cord, intervertebral disks, and nerves. In addition to supporting your head’s weight, your cervical spine allows for a wide range of head movement.

Additionally protecting your spinal cord is the circular bone that protects it. Diseases and disorders of the cervical spine can have a variety of effects on you. Fortunately, there are a number of surgical and nonsurgical treatments available to address these issues.

FAQ:

References:

• Expert, C. C. M. (n.d.-a). Cleveland Clinic’s cervical spine division. This is a link to an article about cervical spine surgery (22278).

• On February 8, 2024, Dhameliya, N. The anatomy, structure, function, and muscles of the cervical spine. Exercise and Physical Therapy Treatment. Cervical Spine Physical Therapy, Inc.