ANATOMY AND BIOMECHANICS

OF THE CERVICAL SPINE

Spine
 Vertebral column:
 a curved stack of 33 vertebrae
structurally divided into five
regions:
 cervical region - 7 vertebrae
 thoracic region - 12 vertebrae
 lumbar region - 5 vertebrae
 sacrum - 5 fused vertebrae
 coccyx - 4 fused vertebrae
 Regions of the Spine
 Cervical
 Upper cervical: C1-C2
 Lower cervical: C3-C7

• Thoracic: T1-T12

• Lumbar: L1- L5

• Sacrococcygeal: 9 fused
vertebrae in the sacrum and
coccyx
Cervical Lordosis

Thoracic Kyphosis

Lumbar Lordosis
Cervical Spine
 The 7 vertebrae of the cervical spine are divided
into
 Upper cervical spine
 C0-C1-C2 (Occiput-atlas-axis)
 Allow for greater mobility
 No intervertebral disc (IVD)
 Lower cervical spine
 C3-C7
 Vertebral structures are similar
 Disc at every level
 Atlas (C1)
Anterior Articular Facet
Tubercle for Dens
Transverse
Process
Superior
Articular
Facet

Transverse Lateral
Foramen Mass
Posterior Lamina
Tubercle
Superior View
Axis (C2)
Body Odontoid Lateral
Process Mass
(Dens)

Superior
Articular
Facet

Inferior
Articular Spinous
Transverse
Facet Process
Process
Anterior View Posterior View
 Lower Cervical Vertebrae (C3-C7)

 C3 to C7
 May be referred to as
the subaxial region
 Disc at every level
 Vertebral structures
are similar
 Lower Cervical Vertebrae (C3-C7)

Sulcus for Transverse

Body Process
Spinal Nerve
Transverse
Foramen
Pedicle

Superior
Lateral Articular Facet
Mass

Vertebral
Lamina Foramen

Axial View Bifid Spinous Process

Vertebra Prominens (C7)
 C7 is referred to as the
VERTEBRA PROMINENS
because it has a longer and
larger spinous process than
the other cervical vertebrae.
 This spinous process is not
usually bifid.
Spinous
Process

Axial View
Joints
 Occipito-Atlantal Joint (OA Joint)
 Atlantoaxial Joint (AA Joint)
 Facet Joint (Zygapophyseal Joints)
 Joint of the Lower Cervical Vertebrae
(C3 - C7)
 Uncovertebral Joint (Joint of Luschka)
Occipito-Atlantal Joint (OA Joint)

Occipital
Condyles
Foramen
Magnum
articulate with
C1 superior
facets
Occipito-Atlantal Joint (OA Joint)
 Articulation between the atlas and the occipital
bone
 Synovial joint
 The movements permitted in this joint are:
 Flexion and extension (nodding of the head)
 Slight lateral motion
Atlantoaxial Joint (AA Joint)
 JOINT between the
Dens
atlas (C1) and the axis
(C2); has a range of
motion in the transverse
C1
plane for rotation.
 The DENS of C2 acts
as a pivot point for the C2
rotation of C1.
Zygapophyseal
joints
Facet Joint (Zygapophyseal Joints)
 The facet joints are formed by the articular processes of adjacent
vertebrae. The inferior articular process of a vertebra articulates
with the superior articular process of the vertebra below.
 These are synovial gliding joints
 Allow flexion-extension, side bending, and rotational
movements.

Facet Joint
(Zygapophyseal)
Facet Joint
(Zygapophyseal)
Joint of the Lower Cervical Vertebrae
(C3 - C7)
 The vertebral bodies of the subaxial cervical spine have upward projections on the
lateral margins called UNCINATE PROCESSES.
 These processes articulate with the level above to form the UNCOVERTEBRAL
JOINT. These are also called JOINTS OF LUSCHKA.
Uncinate
Process

Uncovertebral Joint
Sulcus for
(Joint of Luschka)
Spinal Nerve

Anterior View
 Ligaments
 Upper Cervical Ligaments:  Lower Cervical Ligaments:
 Occipito-atlantal Ligament
Complex
 Anterior Longitudinal
 Anterior Occipito-atlantal Ligament Ligament (ALL)
 Posterior Occipito-atlantal Ligament
 Lateral Occipito-atlantal Ligament
 Intertransverse ligaments
 Occipito-axil Ligament Complex  Posterior longitudinal
 Occipito-axial ligament ligament
 Alar ligament
 Apical ligament
 Interspinous ligament
 Transvers ligament  Supraspinous ligament
 Ligamentum flavum
 Upper Cervical Ligaments

Occipito-atlantal Ligament Complex

Anterior
occipitoatlantal
ligament

Lateral Posterior
occipitoatlantal occipitoatlanta
ligament ligament

Anterior View
 Upper Cervical Ligaments

Occipito-atlantal Ligament Complex

Posterior cutaway view

Posterior
Occipito-axial
ligament
 Upper Cervical Ligaments

Atlanto-Axial Ligament
Posterior view

Apical
ligament Alar ligaments (2)
Lower Cervical Ligaments

Intertransverse
ligaments

Anterior
Longitudinal
Ligament
(ALL)
Lower Cervical Ligaments

Posterior longitudinal ligament

Lower Cervical Ligaments

Interspinous
ligament

Supraspinous
ligament

Ligamentum
flavum
Muscles
 Flexor muscles
 Extensor muscles
 Lateral flexors muscles
Flexor Muscles
 Rectus capitus anterior
 Rectus capitis lateralis
 Longus capitis
 Longus colli
 Eight pairs of hyoid muscles
Flexor Muscles
Flexor Muscles
Extensor Muscles
 Splenius capitis
 Splenius cervicis
 Assisted by:
 Rectus capitis posterior major and minor
 Obliquus capitis superior and inferior
Extensor Muscles
Lateral Flexors
 Sternocleidomastoid
 Levator scapulae
 Scalenus anterior, posterior, & medius
 Plus the cervical flexors and extensors when
developing tension unilaterally
Lateral Flexors