Anatomy-Lexicon

The cervical spine (cervical spine)

Synonyms

Cervical spine, cervical vertebrae, cervical vertebrae, cervical body

anatomy

The cervical spine (Cervical spine) is part of the spine as a whole, also known as the backbone.
There are 7 cervical vertebrae (vertebrae cervicales) that connect the head to the trunk. While the lower 5 cervical vertebrae are similar in structure, the first two cervical vertebrae are different in structure.
The first, ring-shaped cervical vertebra (atlas) represents the transition from the head to the cervical spine. Here, the spinal cord enters the vertebral canal as an extension of the brain. Towards the skull there is a pair of joints (antlantocipital joint). The 2nd cervical vertebrae (axis) has a special feature of a front pin (dens axis) that protrudes upwards into the ring of the atlas.

The vertebral bodies of the cervical spine (cervical spine) are joined together in a stable row. The vertebral bodies are connected to one another by paired vertebral joints to the neighboring vertebrae.
Between the vertebral bodies are the intervertebral discs, which are important for the mobility of the spine and which buffer axially acting forces.
Numerous ligaments and muscles run between the vertebral bodies, which are important for the movement and stability of the cervical spine.

Illustration of the cervical spine

Cervical spine (red)

First cervical vertebra (carrier) -
Atlas
Second cervical vertebra (turner) -
Axis
Seventh cervical vertebra -
Vertebra prominent
First thoracic vertebra -
Vertebra thoracica I
Twelfth thoracic vertebra -
Vertebra thoracica XII
First lumbar vertebra -
Vertebra lumbalis I
Fifth lumbar vertebra -
Vertebra lumbalis V
Lumbar cruciate ligament kink -
Promontory
Sacrum - Sacrum
Tailbone - Os coccygis

You can find an overview of all Dr-Gumpert images at: medical illustrations

The cervical spine naturally has a slight curvature when viewed from the side (Lordosis). The spine is curved convex forward here.

The single cervical vertebra consists of one Vertebral bodies (Corpus vertebra), a Vertebral arch (Arcus vertebra), 4 small vertebral joints (right and left, above and below), a spinous process (processus spinosus), a transverse process and a vertebral hole (foramen vertebrale) formed by the vertebral arches. The vertebral hole of a single vertebral body, together with the other vertebral holes, forms a bony canal, the vertebral canal or spinal canal (spinal canal).
The spinal cord runs in the spinal canal, and in an adult it ends approximately at the level of the second lumbar vertebral body. Together with the neighboring vertebral bodies (above and below), an outlet opening for the spinal cord nerves is formed (intervertebral foramen; neuroforamen).

Appointment with a back specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Illustration of the spine

Figure spine: A - from the left and B - from the front

First cervical vertebra (carrier) -
Atlas
Second cervical vertebra (turner) -
Axis
Seventh cervical vertebra -
Vertebra prominent
First thoracic vertebra -
Vertebra thoracica I
Twelfth thoracic vertebra -
Vertebra thoracica XII
First lumbar vertebra -
Vertebra lumbalis I
Fifth lumbar vertebra -
Vertebra lumbalis V
Lumbar cruciate ligament kink -
Promontory
Sacrum - Sacrum
Tailbone - Os coccygis
I - cervical spine (red)
II - thoracic spine (green)
III - lumbar spine (blue)

You can find an overview of all Dr-Gumpert images at: medical illustrations

Figure spine

Transverse process
outgoing nerve
Vertebral bodies
Spinous process
Spinal cord

Function of the cervical spine

The cervical spine (Cervical spine) carries the head. In this respect, it is of great importance as a static organ. The movements of the head are also carried out by the cervical spine.

The overall mobility of the spine is great, although only relatively small movements are possible between the individual vertebral bodies. By adding up these small ranges of motion, the result is the large total range of motion.

The cervical spine and especially the lower cervical vertebrae have the greatest freedom of movement. Movements in all directions are possible. Rotation, flexion, inclination, extension (dorsiflexion, reclination) and sideways inclination (lateral flexion) are possible.
The large range of motion is mainly made possible by the vertebral joints, which have an approximately horizontal orientation in the cervical spine.

The smallest functional (movable) unit of the spine is the movement segment. A movement segment is understood to be the unit between two neighboring vertebral bodies, which are connected to one another via two vertebral joints, as well as the intervertebral disc between the vertebral bodies and all muscular structures, ligament and nerve structures that are located in this area.

Isolated disorders are often found in a single movement segment (e.g. blockages, herniated discs). For a local description of a spinal disease, the individual vertebral bodies are counted, e.g. HWK 5 for the 5th cervical vertebrae, BWK 9 for the 9th thoracic vertebrae, LWK 3 for the 3rd lumbar vertebrae, etc.
It is the same with the intervertebral discs and the movement segments. The description of HWK 4/5 refers to the movement segment between the 4th and 5th cervical vertebrae.

In addition to its function as a static organ and as an organ of movement, the spine has another important function as a protective and conducting organ for the spinal cord. The spinal cord basically represents the extension of the brain and is therefore also assigned to the central nervous system.

Also read our topic: Ligaments of the spine

Diseases

Pain in the cervical spine is very common. In such cases, a non-specific description of pain is also referred to as a cervical spine syndrome. A characteristic sign of sudden cervical spine complaints is the oblique relieving posture or forced posture of the head, the torticollis.

Disc changes, e.g. A herniated disc of the cervical spine can cause characteristic pain radiating into the arm (cervicobrachialgia). Other forms of intervertebral disc wear (osteochondrosis) without a herniated disc increasingly lead to the implantation of an artificial disc (disc prosthesis).

Severe signs of wear and tear on the vertebral joints can cause facet syndrome. This is a local clinical picture, which is characterized by movement and resting pain of the cervical spine and at the same time by restricted movement of the cervical spine. Pain radiating to the head is also common (cervicocephalgia).

Severe wear-related (degenerative) narrowing of the spinal canal in the cervical spine (spinal stenosis of the cervical spine) can damage the cervical spinal cord and lead to the clinical picture of cervical myelopathy, which is characterized by loss of strength and increasing paralysis of the arms and legs. In these cases, pressure relief (decompression) of the spinal cord and usually also a stiffening operation (spondylodesis) is necessary.

Slipping of the vertebral body (spondylolisthesis), which often occurs in the lumbar spine, only occurs in the cervical spine due to degenerative changes.

Harmless, but very common, cervical spine and neck pain is caused by muscular tension. The muscular tension is often an expression of a stress reaction provoked from within or from outside.

Cervical spine discomfort

The complaints caused by a damage Can be caused in the cervical spine differ depending on Altitude localization the disorder.
Depending on which complaints occur, conclusions can often be drawn as to the part of the cervical spine in which the impairment is present.
Strength a headachethat extend from the back of the head to the forehead indicate a disorder in the upper area the cervical spine. Same goes for Tingling or numbness in the back of the head and forehead area. Are the complaints mainly through Shoulder pain and problems with lateral lifting of the arm, the cause could be a disturbance at the level of the 4th / 5th Vertebral body lie. The deeper the affected vertebral bodies sit, the further downward the complaints are projected. At a Disturbance of the 5th / 6th Cervical vertebra can therefore range up to sensory disorders thumb and index finger occur and the Flexion in the elbow joint to be disabled. Damage at the level of 6./7. Cervical vertebrae also cause sensory disturbances back of Hand and the remaining fingers. The extension of the elbow joint can also be restricted.

All of these complaints can of course also have other causes. To step Sensory disturbances or Signs of paralysis a doctor should be consulted for further clarification.
If a cervical vertebra is blocked, a Physiotherapist or chiropractor help to release the blockage. The symptoms then usually subside immediately.
Unauthorized attempts to correct the blocked vertebra should be avoided, as this can lead to serious injuries.
Often the complaints are also caused by a tense muscles triggered. Help in this case Massages, heat applications or muscle relaxing drugsto relieve the pain.
Is the complaint Herniated disc of the cervical spine basis, a doctor must decide whether a conservative therapy it is a possibility. Otherwise a surgical intervention become necessary.

As a prophylactic, it is advisable to ensure sufficient exercise in everyday life. Stretching and strengthening exercises prevent signs of wear and tear and injuries to the cervical spine, but can also significantly alleviate existing symptoms.

Pain in the cervical spine

Cervical spine pain is also called Cervical spine syndrome, referred to as the cervical spine syndrome for short. This is a collective term for all pain conditions of the cervical spine, which can also radiate into the arms or the shoulder region.

Causes:
The possible causes of a cervical spine syndrome are many. They range from acute pain by Tension the neck and neck muscles Vertebral joint blockages up to Changes of the Band washers, Tapes or Vertebral bodies.
In particular, the bony abnormalities can also be congenital (for example Scoliosis) or due to wear and tear.
This is an acute cause of cervical spine syndrome Whiplash trauma, which is mostly in the context of Car accidents occurs when the occupant's head is first thrown forward and then against the headrest.
Also inflammatory diseases can cause cervical spine syndrome. These include, for example Rheumatoid arthritis, of the ankylosing spondylitis and the Spondylitis, or. Spondylodiscitis. Diseases that affect the bone substance, for example osteoporosis or Osteomalacia, can also cause pain in the cervical spine. In osteoporosis, the pain is usually caused by secondary break-ins (Fractures) of the vertebral bodies.
Last but not least, a cervical spine syndrome can also be caused by tumors in the area of the cervical spine or other colonizations there Tumors caused.

Symptoms:
Pain in the cervical spine can extend into the Arms, shoulders and in the Shoulder blade area radiate. Turning the head is often restricted and painful, especially if the cause is a blockage of the vertebral joints or tense neck muscles.

Therapy:
For acute pain in the cervical spine due to Tension it can help with the tense muscles local narcotics to infiltrate. This can, for example, from Family doctor be made. The anesthetic is injected into the muscles of the neck area at various points. The person concerned usually feels an improvement quickly. The anesthetic creates a Pain-related poor posture avoided so that the symptoms do not worsen further. Also warmth and Massages can loosen tension in the neck area. If there is a more serious cause, it must be decided on an individual basis which therapeutic measure is appropriate. Often an imaging in the form of a MRI or CT so that the attending physician receives clues as to the exact cause of the symptoms.
If there is a degenerative change in the cervical spine and conservative therapeutic measures no longer help, it may also be necessary to have one surgical intervention to be thought about.

A Whiplash trauma can remain painful for a long time after the accident. However, people should not hold their necks convulsively still or with a Ruff calm down, but move carefully at first. Complete immobilization has proven to be detrimental to the symptoms.
Physiotherapy exercises can besides Painkillers cause a speedy recovery.

Appointment with a back specialist?

I would be happy to advise you!

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Herniated disc of the cervical spine

A herniated disc of the cervical spine is more likely Rare (approx. 15% of all herniated discs).
The most common are herniated discs Lumbar spine, as this is more stressed. If there is a herniated disc on the cervical spine, this mainly affects elderlythat show significant signs of wear and tear on the cervical spine.
By Cartilage abrasion, Loosening of the tape and a muscular weakness such a herniated disc is favored in the neck area.
Another cause are Traumain which strong forces act on the cervical spine. This can also lead to the internal mass of the intervertebral disc swelling out (Prolapse). The most common are the intervertebral discs between the 5th and 6th, or the 6th and 7th Vertebral bodies affected.
It is not uncommon for a herniated disc to occur in the cervical spine constant bad posture of the head, for example through a constantly cramped body position. This often affects people who move little, for example in the office work and therefore sit for a long time and keep your head still. In the long run, this can lead to damage to the intervertebral discs. When used, they tear faster and the inner mass of the intervertebral disc swells out. This presses on the annoythat protrude between the vertebral bodies, causing the classic symptoms of a herniated disc.

Symptoms

A herniated disc in the cervical spine can cause different symptoms depending on the location of the incident and its severity.
Typical complaints are:

shooting pain in the supply area of the nerves squeezed by the dislocated disc mass
Sensory disorders of the skin in the shoulder or arm area
Knocking pain over the damaged disc
painful Restriction of mobility the cervical spine.
Restriction of motor skills up to paralysis

In the worst case, a herniated disc can also cause paraplegia if it presses the spinal cord. However, this is rare, especially in the case of the cervical spine.

Diagnosis

The best diagnosis for detecting a herniated disc in the cervical spine is an MRI.
The MRI is a radiation-free examination that creates layer images of the cervical spine.
Further information on this topic can also be found at: MRI of the cervical spine

therapy

If possible, a herniated disc will be the cervical spine conservative treated, that means you want one surgery Avoid if possible. In this case, for example, are used Painkiller, muscle relaxing drugs (Muscle relaxants) and physical therapy. Special exercises for the neck muscles (for example Back school) can in most cases, in combination with adequate pain medication, bring about a sufficient improvement in the symptoms so that an operation can be avoided.

If these conservative measures are not sufficient, a surgical intervention (operation of the herniated disc) must be considered. In the case of herniated discs that have already led to symptoms of paralysis, surgery is usually carried out directly.
The surgical access is often at the level of the Larynx elected from the front. The surgeon works his way up to the cervical spine, can peel out the defective intervertebral disc and put it through a artificial disc of the cervical spine or replace a spacer. As a spacer, for example, a Titanium basket serve, which can be placed in the place of the old intervertebral disc and filled with bone mass.

Therapy of a herniated disc of the cervical spine
and
Operation of a herniated disc of the cervical spine

prophylaxis

In order to avoid a herniated disc of the cervical spine, should be on a adequate physical activity be respected. Movement is important to avoid one-sided stress on the intervertebral discs. In this way, the intervertebral discs are less stressed and do not tear as quickly. Training also has a protective effect on the neck muscles, as the muscles stabilize the cervical spine. Targeted Relaxation and strengthening exercises for the neck are therefore particularly suitable for people with little movement and one-sided stressful situations (PC work).

Pinched nerve in the cervical spine

A pinched nerve is very stressful and painful.

A pinched nerve can be very painful.
Tense muscles are often the cause. In the area of the cervical spine, muscle hardening can arise, for example, due to incorrect posture or excessive strain, but also due to wear and tear on the cervical spine.
If this puts pressure on a nerve, it can lead to shooting, severe pain. A tingling sensation or numbness in the supply area of the corresponding nerve (dermatome) can also occur.
Tingling or numbness can be triggered by various causes.
If you suspect a herniated disc as the cause of your symptoms, we recommend our topics:

Numbness indicating a herniated disc
and
Tingling sensation as a sign of a herniated disc

Many people have pronounced tension in the neck and shoulder area. Accordingly, symptoms from irritated or pinched nerves are common. In the head and neck area, this often leads to head or neck pain, which can radiate into the arms or upper back area.
If the cause lies in the tense muscles, warmth and muscle relaxants and pain relievers can help to alleviate the symptoms. As a result, the person concerned takes less of a protective posture, which could otherwise lead to a further worsening of the symptoms. The tension can be released through targeted massages. In order to prevent this in the future, it is advisable to perform regular loosening and strengthening exercises for the neck and shoulder muscles.

More on this: Pinched nerve

Adjust the cervical spine

At postponed or blocked Vertebral joints In the area of the cervical spine, no attempt should be made to correct the misalignment on your own initiative. This can be very dangerous as it is important in the neck area near the vertebrae Vessels direction brain run away. In the worst case, incorrect handling can damage these vessels. Bleeding is the result. These could potentially also be one stroke trigger when the brain is no longer adequately supplied with blood in places due to an injury to a supply vessel.
However, the connection between straightening and the occurrence of strokes has not been scientifically proven. However, if the cervical spine is blocked, a professional should definitely be sought (Chiropractor) to be visited. This can Articular surfaces Align them optimally to each other and restore the correct position with a short, quick impulse on the joint. This method is called "Manipulation" designated. The better the practitioner masters this technique, the less force he has to use and the less likely it is that annoy, Vessels or Band structures get hurt. From "Adjust“However, one does not speak in chiropractic. This is just a Lay term, since it is not actually a dislocated vertebra, only Blockages of small vertebral joints acts. The cracking, which can often be heard when the blockage is released, is caused by pulling the joint surfaces apart.
It is important that prior to manipulation of blocked spinal joints an assessable X-ray image was made. This is the only way for the therapist to rule out serious illnesses such as tumors of the spine, which may not be manipulated under any circumstances. This could potentially cause serious complications. Only when such serious causes for the complaints have been ruled out can the manipulation be carried out.

Grinding cervical spine

Crunching noises in the cervical spine can have various causes.

To a certain extent, cracking noises when turning the head are normal because the small vertebral joints that are located between the individual cervical vertebrae are shifted against each other. This can lead to such noises. Is it more like a sandy rubbingso it can also be a Wear and tear act of the cervical spine. Will the cervical vertebrae through Bad posture or excessive stress If used too much, this can in the long run too Cartilage abrasion on the joint surfaces and subsequently also to bone damage. Abraded pieces of cartilage or protruding bones can then cause a crunch when the head is rotated.

A medical clarification of the symptoms can therefore make sense. In such a case, a targeted one is recommended physiotherapy trainingto strengthen the neck muscles. This can then stabilize the cervical spine better and prevent further damage.