CT Scan of the Cervical Spine

The images below are reconstructions obtained from a scan of the cervical spine. Each row of three thumbnails correspond to a given level and the green cross indicates the reference planes for each image of this Level.

Clinicians use a computed tomography (CT) scan to diagnose a particular disorder or disease and detect tumors, brain damage, and vascular or bone irregularities(1). These diagnostic examinations are essential in verifying specific medical conditions.

CT scans on the cervical spine can help radiologists identify infection, breaks in the spinal column, or abnormal mass of tissues in the spine (tumors)(2). This procedure can determine spinal diseases, such as herniated disc or spinal stenosis (narrowing spine)(3).

Anatomy of the Cervical Spine

The cervical spine is composed of the first seven vertebrae in the spine(4). Located below the skull, it ends before the thoracic spine (longest region of the spine)(5)

The cervical spine’s seven vertebrae are the C1 vertebrae (atlas), C2 vertebrae (axis), C3 vertebrae, C4 vertebrae, C5 vertebrae, C6 vertebrae, and the C7 cervical vertebrae. The C3 to C6 vertebra consists of the following bone structures(6):

  • Vertebral body
  • Transverse Processes (TVP)
  • Spinous Process
  • Vertebral foramen
  • Vertebral arch
  • Articular Processes
  • Vertebra Prominens

The atlas and the axis are the atypical cervical vertebrae, allowing the head’s movement (7)

Also known as C1 vertebrae, the atlas is a ring shape that produces lateral masses (bony junction between inferior and superior articular processes) and is connected by the posterior and anterior arches(8)

Meanwhile, the axis (C2 vertebrae) is comparable to most cervical vertebrae in the spine(9). It is made up of the dens or the odontoid process, which joins the main body of the vertebra. These odontoid processes (dens) are encircled by the atlas(10-11).

Meanwhile, the bone structures in the C3 to C6 vertebrae of the cervical spine are called typical cervical vertebrae. 

The vertebral body includes the uncovertebral joints or four planes of synovial joints(12). These joints are not directly joined together. Instead, they are closed with the articular capsule (envelope surrounding the synovial joint that prevents friction).

The transverse processes (TVP) function as the passage of the spinal nerves. They are divided into posterior and anterior tubercle, used for the attachment of muscles(13).

The spinous process projected posteriorly lies underneath the skin on the back and tends to be bifid (divided into two parts) and short(14).  

Meanwhile, the bony canal where the spinal cord runs is called the vertebral foramen(15). It is a large, triangular shape that supports all innervation to the upper limb and accommodates the expansion of the cervical part of the spinal column(16)

The vertebral foramen contains a posterolateral bony element called the vertebral arch(17)

Moreover, in the posterior part of the transverse process and its foramen transversarium, the articular processes are located. These articular processes have two posteriors and two anterior processes with smooth surfaces (articular facets)(18).

These articular processes can also be referred to as the vertebral arch joints because these processes form lateral bony elements in the arch(19).

Vertebra prominens (C7) is the longest vertebra that is easily examined when the head is flexed forward(20). It is smaller than the transverse process and contains vertebral veins only(21).

The cervical spine is the more movable part of the spinal column(22). It has distinct openings for the arteries to carry blood to the brain and away from the heart. There is also a spinal canal where the spinal column extends(23)

Even though the cervical spine is relatively more flexible and mobile, this part of the spine is at high risk for whiplash-type injuries or sudden strong movements. These risks are due to the limited muscle support in this area(24).

Clinical Significance of CT Scan of Cervical Spine

Spinal disorders caused by accidents or trauma can be examined and diagnosed through computed tomography (CT) scan.

This procedure uses X-rays to produce two-dimensional images of the bones, tissues, and organs(25). It is a noninvasive diagnostic procedure that produces a more detailed image compared to X-rays(26).

CT scans allow clinicians to see different angles of the interior organs and structures of the body. They evaluate spine lesions, tumors, structural anomalies, and herniated disks in the spinal column(27).

Some of the cervical spine disorders that may be diagnosed through CT scans are the following(28):

  • Cervical spinal stenosis (spinal canal narrowing)
  • Cervical herniated disc (ruptured or damaged spinal disc)
  • Cervical myelopathy (spinal damage caused by degeneration)
  • Cervical spondylosis (wearing out of cartilage or vertebrae)
  • Cervical radiculopathy (compression or pinched nerve)

The CT scan procedure may be done with or without a contrast dye that can be taken orally or through an IV(29). A contrast dye is a solution used to emphasize the images of the internal organs, tissues, and structures(30).

Potential Risks of CT Scan

Although CT scan is useful in diagnostics, there are some risks associated with this procedure. 

CT scans expose patients to more radiation compared to X-rays(31). Repeated CT scans can increase the risk of cancer resulting from these radiations(32)

Moreover, some people are allergic to the contrast dye used during a CT scan. For people allergic to iodine (commonly used for contrast dye), some side effects include hives, itching, nausea, and sneezing(33).

  1. NIH National Institutes of Neurological Disorders and Stroke, (n.d.), Neurological Diagnostic Tests and Procedures Fact Sheet, retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurological-Diagnostic-Tests-and-Procedures-Fact#:~:text=CT%20scans%20also%20may%20be,different%20tissues%20in%20the%20brain.
  2. My Health Alberta, (n.d.), CT Scan of the Cervical Spine — About This Test, retrieved from https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ug6626
  3. Ibid.
  4. University of Maryland Medical Center, (n.d.), Cervical Spine Anatomy, retrieved from https://www.umms.org/ummc/health-services/orthopedics/services/spine/patient-guides/cervical-spine-anatomy?__cf_chl_jschl_tk__=6e92cdbb833a302e64beb9ef4c28710e1e88fd8b-1611091270-0-AatiPfZKDmSGZSkIejAYwzxXF2p5Nr0LAh8jVSsdzy2qkyUF5eTcsEYnI4DtQr0uUzCVJqYEJ5YmoLjzQ8wZUmoA_wriJuL6la_vvqRuqODifPT-YRwW0nh4Xz4h7X8PNif1BeenARmEOObsnQqq8rUHaSg20-sl6C9AZ6OTyb7mDx-lDMFTzXiFzBoCY_y-wak7prNRK11YMmEVyZiDjTXeLqXoNC9iMtggWHhzKw6VErNpl6LkMjh1J_cU0_PCEKWzqycI_S4Uuq0xWAjpVEecVJG85EeTU6VAsJbkKbrzn_zPwU5vfbRG-_h2ofsrcowd2mWOLZLlAbnwjiPe-VIRp-w5Mcpo7aWbGlaCEZWW_tBzd2KphiA46R3fgfGSC1FnOM0POclvGidr9i7dO9Dcm4ncYdnG5JfTTlXbuJtdpAk83eRNV1B3r3LJgpQ9bNBdu_CKTqCKYG-BqKYinBRHPI6zwX6qBnYXFgK-1cxR
  5. IBID.
  6. Perry, C., (October 2020), Cervical spine, Ken Hub, retrieved from https://www.kenhub.com/en/library/anatomy/cervical-spine
  7. Ibid.
  8. Ibid.
  9. Ibid.
  10. Physio Pedia, (nd.), Odontoid Process, retrieved from https://www.physio-pedia.com/Odontoid_process#:~:text=The%20odontoid%20process%20(also%20dens,main%20body%20of%20the%20vertebra.
  11. Perry, C., Op Cit.
  12. Ibid.
  13. Ibid.
  14. Ibid.
  15. Ibid.
  16. Ibid.
  17. Ibid.
  18. Ibid.
  19. Ibid.
  20. Perry, C., (October 2020), Cervical Spine), retrieved from https://www.kenhub.com/en/library/anatomy/cervical-spine
  21. Ibid.
  22. University of Maryland Medical Center, Op. Cit.
  23. Ibid.
  24. Ibid.
  25. NIH National Institutes of Neurological Disorders and Stroke, Op. Cit.
  26. John Hopkins Medicine, (n.d.), Computed Tomography (CT or CAT) Scan of the Spine, retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ct-scan-of-the-spine
  27. Ibid.
  28. University of Miami Health System, (n.d.), Cervical Spine Disorders, retrieved from https://umiamihealth.org/en/treatments-and-services/physical-medicine-and-rehabilitation/cervical-spine-disorders#:~:text=Cervical%20spine%20disorders%20involve%20the,stress%2C%20smoking%2C%20or%20aging.
  29. Ibid.
  30. Radiology Info, (n.d.), Contrast Materials, retrieved from https://www.radiologyinfo.org/en/info.cfm?pg=safety-contrast
  31. University of California San Francisco, (n.d.), Cervical Spine CT Scan, retrieved from https://www.ucsfhealth.org/medical-tests/007351
  32. Ibid.
  33. Ibid.
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