The cervical vertebrae are composed of cylindrical bones (vertebral bodies) that lie in front of the spinal cord, and work with the muscles, joints, ligaments and tendons to provide support, structure and stabilization to the neck.
The first cervical vertebra is unique in that it is a ring that rotates around the second vertebral body (the odontoid). The cervical vertebrae closest to the skull are the smallest. All of the cervical vertebrae are smallerthan the vertebrae in the thoracic spine (upper back) and the lumbar spine (lower back).
Cervical Vertebrae Roles and Responsibilities
Stacked on top of each other with a cervical disc in between them, the cervical vertebrae provide strength and structure to the cervical spine and support the head. The cervical vertebrae also provide for structure and control of certain types of movement in the neck (with the movement described in terms of the two vertebral bodies that are connected), including:
- Rotation(moving the head from side to side). Most rotation of the neck takes place in the first two segments of the cervical spine, specifically the atlas (C1) and the axis (C2).
- Flexion(moving the head forward) and extension(moving the head backward). Most flexion and extension movements in the neck are controlled by the C5-C6 and C6-C7 segments of the spine. Unlike the first two cervical vertebrae, the remaining five cervical vertebrae, C3 through C7, are constructed more similarly to the rest of the spine, with three joints making up each vertebral segment (a disc in the front and two facets joints in the back)
Cervical Pain from Degeneration and Injury
Cervical Degeneration: Bone Spurs and Cervical Osteoarthritis
A bone spur (medically known as an osteophyte) describes an enlargement of the facet joints, the small stabilizing joints that are located between and behind the adjacent cervical vertebrae. Bone spurs are smooth structures that can grow on the bones and tend to occur in adults over 60 years of age.
Patients with cervical bone spurs may or may not have symptoms, which could include neck pain and/or referred pain and weakness in the arms and the legs. For example, patients with cervical bone spurs may experience dull neck pain that occurs when standing. In some instances, the pain may be referred to the shoulders or prompt headaches.
However, it must be emphasized that the presence of bone spurs in and of themselves does not necessarily mean this is what is generating a patient’s pain. Most bones spurs are simply radiographic findings indicating a patient has degeneration in the neck.
Bone spurs may form as the result of cervical osteoarthritis, a condition marked by degeneration and breakdown of the cartilage between the facet joints in the cervical spine. With cervical osteoarthritis (also known as cervical arthritis), different symptoms may occur, such as pain that:
- Refers to the shoulder or between the shoulder blades
- Feels worse at certain times of the day (early in the morning, late at night)
- Calms with rest.
Rarely requiring surgery (such as when there is a vertebral fracture in the neck), cervical osteoarthritis is typically treated via rest, pain medications, chiropractic and/or traction.