Of the seven cervical vertebrae, C3 through C6 have typical anatomy, while C7 looks very similar. C1 (atlas) and C2 (axis) have very distinct anatomical features. For a basic anatomic description of the structure a generic vertebra, see vertebrae.

Gross anatomy

• small, oval-shaped vertebral bodies

• relatively wide vertebral arch with large vertebral foramen

• relatively long, bifid (except for C7) inferiorly pointing spinous processes

• transverse foramina protecting the vertebral arteries and veins

Osteology

Anterior components of the typical cervical vertebra ¹:

• body

• posterolateral lip (uncus)

• pedicle

• transverse process

  • anterior and posterior tubercle of the transverse process

  • intertubercular lamella of the transverse process

  • foramen of the transverse process

Posterior components of the typical cervical vertebra ¹:

• lamina

• bifid spinous process

• superior articular process

• inferior articular process

Articulations

• intervertebral disc (superior and inferior): interposed between hyaline cartilage on the centrum of the vertebral bodies

• uncovertebral joint ²: the superior surface of the vertebra below curves upward to form a hyaline covered lip. The lip articulates with the inferior bevelled surface of the vertebra above; this occurs bilaterally, and thus the intervertebral foramen in cervical vertebrae is bordered anteriorly by both the cervical vertebrae from above and below (as opposed to above alone)

• facet (zygapophyseal) joint: articular processes lie at the junction of the pedicle and lamina, and the articular surface can be viewed as a cylinder sliced obliquely

  • upper facets face obliquely up and back

  • lower facets face down and forward

Blood supply

• arterial: segmental branches from ascending cervical and vertebral arteries

• venous: basivertebral veins, internal vertebral venous plexus, external vertebral venous plexus

Variant anatomy

• variable presence of bifid spinous processes

• variable length of spinous processes

• blocked or fused vertebrae

• accessory transverse foramina

• accessory articulation between cervical transverse processes ⁴

Radiographic features

Plain radiograph

• lateral view: if the patient is supine, this view will allow for all 7 vertebrae to be seen ¹

• swimmers view: another lateral view where the patient will have one arm up and one down ¹; provides views of the cervicothoracic junction

• AP view ¹

• AP open mouth: allows for assessment of C1 and C2 alignment and the dens

• oblique view: for facet joints and intervertebral foramina ¹

Related pathology

• fractures

  • clay-shovelers fracture

  • flexion teardrop fracture

  • extension teardrop fracture

• osteoarthritis

• rheumatoid arthritis