The lower cervical spine or subaxial cervical spine [As it is below axis vertebra], includes the C3 to C7 vertebral segments. Lower cervical vertebrae have a relatively uniform anatomic configuration.
Anterior Elements
The vertebral body is larger in coronal (left to right) than its sagittal diameter (anterior to posterior). Bilateral prominences called uncinate processes are present along the lateral aspects of the superior end plates. The uncinate processes articulate with rounded inferolateral borders of the superior vertebral body and the articulation is called uncovertebral joint.
This joint marks lateral extent of the vertebral body.
In between two adjacent vertebrae is interposed intervertebral disc. The longus colli muscles lie directly over and insert onto the anterolateral aspects of each cervical vertebra.
The sympathetic plexus lies on top of the lateral muscle belly and may be injured aggressive dissection or retraction which can lead to Horner’s syndrome.
The prevertebral (deep) and alar (superficial) fascial layers separate the spine from the overlying esophagus.
Transverse processes of cervical spine are unique. They contain foramen for vertebral arteryformed by fusion of anterior and posterior part of transverse process and part of pedicle.
Posterior Elements
Pedicles in lower cervical vertebrae project in a posterolateral to anteromedial orientation.
The facet joints are formed by the interaction of superior and inferior articular processes. They are also known as the zygapophyseal articulations. The articular surfaces are angled approximately 45 degrees in relation to the transverse axis. The pillar of bone between the superior and inferior articular processes is commonly referred to as the lateral mass and is It is a useful site for posterior screw or wire stabilization.
The laminae arise from the posteromedial border of the lateral masses project posterior and toward the mid line to form bifid spinous processes. Ligamentum flavum or yellow ligament is present between space between two laminae.
Ligaments like interspinous and supraspinous ligaments or ligamentum nuchae form a posterior ligamentous complex and its disruption may lead to mechanical instability.
Spinal Canal
The spinal canal can be compromised by retropulsed vertebral body fragment, translational displacement in dislocations disc herniations or epidural hematoma.
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