The cervical spine is made up of seven vertebrae that support the head, protect the spinal cord, and help the neck move. Cervical vertebral disorders affect the bones of the neck rather than primarily affecting the intervertebral discs, facet joints, ligaments, spinal cord, or nerve roots.
Please review the Cervical spine anatomy section for more information.
These conditions may develop from aging, trauma, poor bone quality, abnormal development, infection, tumors, or previous surgery. Some vertebral abnormalities are found incidentally and cause no symptoms. Others may produce neck pain, deformity, spinal instability, nerve compression, or spinal cord compression.
Major Diagnosis Types
Below are the major types we see in our clinic. Click on available links to learn about our approach to the problems.
Cervical Vertebral Fractures
A cervical vertebral fracture is a break involving one or more bones of the neck.
The severity of a fracture depends on its location, pattern, displacement, and associated ligament or neurological injury.
Some fractures remain stable and do not threaten the spinal cord. Others create significant instability and may place the spinal cord, nerve roots, or vertebral arteries at risk.
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Cervical Osteophytes
Cervical osteophytes are bone spurs that form along the edges of the cervical vertebrae.
They usually develop in response to chronic degeneration, instability, or increased stress placed on the vertebral joints.
Small osteophytes may cause no symptoms. Larger osteophytes may:
- Narrow the neural foramina
- Compress a nerve root
- Narrow the spinal canal
- Contribute to spinal cord compression
- Limit neck motion
- Irritate nearby soft tissues
Bone spurs that develop along the front of the cervical spine may rarely cause difficulty swallowing or a sensation of pressure in the throat.
The presence of an osteophyte alone does not mean that it is responsible for a patient’s symptoms.
Cervical Spondylosis
Cervical spondylosis is a broad term describing age-related degeneration of the cervical spine.
Although it may involve the discs, facet joints, ligaments, and uncovertebral joints, many of its visible features affect the vertebrae themselves.
These changes may include:
- Bone spur formation
- Hardening of vertebral endplates
- Irregular vertebral margins
- Loss of normal spinal alignment
- Enlargement of joints connected to the vertebrae
- Narrowing around the spinal cord or nerve roots
Cervical spondylosis is extremely common with aging and does not always cause symptoms.
When symptomatic, it may contribute to:
- Chronic neck pain
- Cervical stiffness
- Foraminal stenosis
- Spinal stenosis
- Cervical radiculopathy
- Cervical myelopathy
Cervical Vertebral Bone Lesions
A bone lesion is an abnormal area within a cervical vertebra.
Bone lesions may be:
- Benign
- Malignant
- Infectious
- Inflammatory
- Metabolic
Examples include:
- Bone islands
- Cysts
- Hemangiomas
- Primary bone tumors
- Metastatic cancer
- Multiple myeloma
- Infection-related destruction
Many bone lesions are found incidentally. Others may cause pain, weaken the vertebra, produce a fracture, or extend into the spinal canal.
A vertebral lesion should be interpreted according to its appearance, the patient’s history, and whether it changes over time.
Cervical Vertebral Hemangioma
A vertebral hemangioma is a benign growth made up of abnormal blood vessels within a vertebral bone.
Most vertebral hemangiomas are incidental findings and never cause symptoms. They are more common in the thoracic and lumbar spine but may also occur in the cervical spine.
A typical hemangioma usually does not weaken the vertebra or require treatment.
Rarely, an aggressive vertebral hemangioma may:
- Expand the vertebral body
- Extend into the spinal canal
- Cause vertebral collapse
- Compress a nerve root
- Compress the spinal cord
Symptoms from an aggressive lesion may include pain, weakness, numbness, or difficulty walking.
Postoperative Cervical Vertebral Disorders
Previous cervical spine surgery may occasionally lead to vertebral changes.
Possible postoperative vertebral disorders include:
- Subsidence of a cage or implant into the vertebral body
- Vertebral fracture
- Endplate injury
- Hardware loosening
- Vertebral erosion
- Failure of fusion
- Adjacent-level degeneration
- Progressive deformity
These problems may occur because of poor bone quality, mechanical stress, infection, trauma, or failure of the intended fusion.
Many postoperative changes are mild and remain stable. Others may cause pain, instability, deformity, or neurological compression.