1A Surgical Anatomy of the Cervical Spine

Michael F. O’Brien†

Abstract

Understanding cervical spinal anatomy is imperative to spinal surgeons performing cervical spinal instrumentation. The cervical spine can be separated into three distinct regions based on anatomy and on fixation techniques. The craniocervical junction includes the occiput, the atlas and the axis each requiring highly specialized fixation techniques based on their specialized anatomy. The subaxial cervical spine (C3-C7) can be split into two regions with the mid segments best suited for lateral mass screw fixation due to the presence of the vertebral artery, while the most distal levels (C7 in particular) may also be amenable to straightforward pedicle screw fixation. The use of cervical fixation requires thorough knowledge of the anatomy involved including specific consideration of the anatomy of the vertebral artery in every case to prevent injury.

Key words

cervical spine - vertebral artery - occiput - lateral mass

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