Cervical split

Last revised by Daniel J Bell on 16 Nov 2020

The cervical split is a horizontal lucent line over the cervical body seen on the lateral cervical spine projection, simulating a fracture, observed in the context of proliferative osteophytes of the articulation of the uncinate process 1

In the context of trauma, the cervical split can mimic cervical vertebral body fractures and knowledge of this pseudofracture is an important consideration in the radiographic interpretation of the lateral cervical spine.

As the typical cervical vertebrae sit in the cup-shaped inferior vertebral body with the uncinate processes hugging the lateral body, osteophytes of the uncinate process (extending along the lateral body) and the osteophytes of the superior body will create a horizontal lucency on the lateral projection over the cervical body. 

The cervical split line will often sit more superiorly over the vertebral body, often seen at the C5/6 and C6/7 levels. The margins are quite sclerotic and lack any soft tissue swelling 1

Aside from the radiographic features, one can perform off-lateral or oblique radiographs to confirm it is in fact proliferative osteophytes of the articulation of the uncinate process.

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