Anatomy

The cervical spine is made up of seven vertebrae (C1-C7). A typical vertebra has a body and neural arch. The neural arch is made up of two pedicles and two vertebrae; the laminae meet at the spinous process posteriorly. A transverse process projects out laterally on each side of the pedicle and lamina (Fig. 31-1). The articular processes on the superior and inferior parts of each vertebra at the junction of the pedicle and lamina meet at the facet joints. The first two vertebrae have distinct features. The atlas, C1, articulates with the occipital bone and has no spinous process or body. The axis, C2, has an odontoid process that articulates with C1 (Fig. 31-2); much of the rotational function of the neck occurs at this joint. C7 has a long spinous process, resulting in a palpable prominence below the skin in the lower neck.

Several ligaments stabilize the neck. The anterior and posterior ligaments support the entire vertebral column (Fig. 31-3). The spinous process of each vertebra is attached by the nuchal ligament to the neck and the interspinous ligaments. Intervertebral disks separate each vertebra. Their function is to distribute the pressure over a wider area of the vertebra and allow mobility. Each disk consists of a gelatinous central nucleus and outer fibrous annulus fibrosus. Eight pairs of nerves originate from the cervical spine. The first seven nerve roots exit the spinal canal above the corresponding vertebra, and the eighth nerve root exits from below C7 (Fig. 31-4).

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