Anatomical specificities of the degenerated cervical spine: a narrative review of clinical implications, with special focus on targeted spinal injections.

Abstract:

BACKGROUND:Cervical radiculopathy is most often related to foraminal stenosis due to osteoarthritic changes of the uncovertebral joints anteriorly or zygapophyseal joints posteriorly, rather than disc herniation. OBJECTIVES:To describe anatomical specificities of the degenerated cervical spine. METHODS:A critical narrative review was conducted. Articles were non-systematically selected and based on authors' expertise, self-knowledge, and reflective practice. RESULTS:Vertebral bodies of the lower cervical spine are characterized by 2 lateral prismatic bony protuberances, the uncinate processes, located on C3 to C7 superior vertebral endplates, that are involved in the stabilization of the cervical spine. Degenerative changes at the lower cervical spine can affect different anatomical structures: the intervertebral disc, uncovertebral joints, and facet joints. The incidence and severity of changes increase with age. Furthermore, uncovertebral osteoarthritis is characterized by the presence of transverse fissures in the annulus fibrosus. DISCUSSION:These specific anatomical features of the cervical spine may have clinical implications, including more targeted spinal injections for managing disabling persistent or recurrent symptoms related to cervical spine degenerative changes such as cervical radicular pain.

journal_name

Ann Phys Rehabil Med

authors

Nguyen C,Sanchez K,Roren A,Palazzo C,Falcou L,Drapé JL,Rannou F,Poiraudeau S,Lefèvre-Colau MM

doi

10.1016/j.rehab.2015.12.006

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

276-81

issue

4

eissn

1877-0657

issn

1877-0665

pii

S1877-0657(16)00023-3

journal_volume

59

pub_type

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