Cervical Spine Anatomy

The cervical spine is made up of 7 vertebrae. The first 2, C1 and C2, are highly specialized and are given unique names: atlas and axis, respectively. C3-C7 are more classic vertebrae, having a body, pedicles, laminae, spinous processes, and facet joints.

C1 and C2 form a unique set of articulations that provide a great degree of mobility for the skull. C1 serves as a ring or washer that the skull rests upon and articulates in a pivot joint with the dens or odontoid process of C2. Approximately 50% of flexion extension of the neck happens between the occiput and C1; 50% of the rotation of the neck happens between C1 and C2.

The cervical spine is much more mobile than the thoracic or lumbar regions of the spine. Unlike the other parts of the spine, the cervical spine has transverse foramina in each vertebra for the vertebral arteries that supply blood to the brain.

The cervical spine is made up of the first 7 vertebrae, referred to as C1-7 (see the images below). It functions to provide mobility and stability to the head while connecting it to the relatively immobile thoracic spine. The cervical spine may be divided into 2 parts: upper and lower.

Cervical spine anatomy. Cervical spine anatomy.

Upper Cervical Spine

The upper cervical spine consists of the atlas (C1) and the axis (C2). [1234These first 2 vertebrae are quite different from the rest of the cervical spine (see the image below). The atlas articulates superiorly with the occiput (the atlanto-occipital joint) and inferiorly with the axis (the atlantoaxial joint). The atlantoaxial joint is responsible for 50% of all cervical rotation; the atlanto-occipital joint is responsible for 50% of flexion and extension. The unique features of C2 anatomy and its articulations complicate assessment of its pathology.

Cervical spine. Note uniquely shaped atlas and axiCervical spine. Note uniquely shaped atlas and axis (C1 and