The NP has a gel-like consistency composed mainly of water, which decreases with age (~90% at birth and 70% by the age of 60). The remaining minority of the NP contents then consists of type II collagen and proteoglycans. The AF of the intervertebral discs is mostly of type I collagen in layers (lamellae), proteoglycans, glycoproteins, elastic fibers, and extracellular matrix (ECM) secreting cells. These collagen layers are uniquely positioned to form a strong shell for the inner contents, the NP. The anterior and posterior longitudinal ligaments reinforce the IVD. The IVD is an intricate structure composed mainly of two parts, the peripherally located annulus fibrosus (AF) and the centrally located nucleus pulpous (NP) which are responsible for its’ load distribution function. This joint helps to reinforce the IVD and provides additional stability and motion. In contrast to the thoracic and lumbar vertebrae, the cervical vertebrae have a unique bony prominence called the uncinate process, which articulates with the adjacent level to form the joint of Luschka or uncovertebral joint. The intervertebral disc (IVD) is found from the C2-C3 level down, aids in cervical spine mobility and stabilization. Structures adjacent to the cervical vertebrae include the spinal cord and nerve roots, blood vessels as well as the trachea and esophagus. The upper cervical spine, C1 (the atlas, which articulates with the occiput), and C2 (the axis) are highly specialized, allowing for significant ranges of motion (rotation, flexion, extension, and side-bending) related to facet orientation allowing for more rotation. The cervical spine, C1 to C7, provide exceptional function and range of motion. This chapter will examine the anatomy, natural history, etiology, pathophysiology, evaluation, and treatment options.

Treatment options range from nonoperative measures to decompression, instrumented fusion, or a combination of both laminoplasty or instrumentation or a combination of both. Pain, or in combination with other neurological symptoms, may require surgical intervention. Patients most commonly present with pain.

Degenerative disc disease of the cervical spine typically develops in the aging population equally in terms of patient sex.

Cervical spine levels x ray