A cervical rib in humans is an extra rib which arises from the seventh cervical vertebra. Sometimes known as "neck ribs", their presence is a congenital abnormality located above the normal first rib. A cervical rib is estimated to occur in 0.2% (1 in 500 people) to 0.5% of the population. People may have a cervical rib on the right, left or both sides.

Most cases of cervical ribs are not clinically relevant and do not have symptoms; cervical ribs are generally discovered incidentally. However, they vary widely in size and shape, and in rare cases, they may cause problems such as contributing to thoracic outlet syndrome, because of pressure on the nerves that may be caused by the presence of the rib.

A cervical rib represents a persistent ossification of the C7 lateral costal element. During early development, this ossified costal element typically becomes re-absorbed. Failure of this process results in a variably elongated transverse process or complete rib that can be anteriorly fused with the T1 first rib below.

On imaging, cervical ribs can be distinguished because their transverse processes are directed inferolaterally, whereas those of the adjacent thoracic spine are directed anterolaterally.

Many vertebrates, especially reptiles, have cervical ribs as a normal part of their anatomy rather than a pathological condition. Some sauropods had exceptionally long cervical ribs; those of "Mamenchisaurus hochuanensis" were nearly 4 meters long.

In birds, the cervical ribs are small and completely fused to the vertebrae.

In mammals the ventral parts of the transverse processes of the cervical vertebrae are the fused-on cervical ribs.

Recent studies have also found a high percent of cervical ribs in woolly mammoths. It is believed that the decline in mammoth numbers may have forced inbreeding within the species which in turn has increased the number of mammoths being born with cervical ribs. Cervical ribs have been connected with leukaemia in human children, so it has given scientists new evidence to believe that the mammoth's extinction was attributed to the condition.

Potential non-surgical treatments include:

- Education about the course of the condition and how to relieve symptoms

- Medicines to relieve pain and inflammation, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs)

- Exercise, to maintain or achieve overall good health, aerobic exercise, such as riding a stationary bicycle, which allows for a forward lean, walking, or swimming can relieve symptoms

- Weight loss, to relieve symptoms and slow progression of the stenosis

- Physical therapy, to provide education, instruction, and support for self-care; physical therapy instructs on stretching and strength exercises that may lead to a decrease in pain and other symptoms

Treatment is usually conservative in nature. Patient education on lifestyle modifications, chiropractic, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and osteopathic care are common forms of manual care that help manage such conditions. Other alternative therapies such as massage, trigger-point therapy, yoga and acupuncture may be of limited benefit. Surgery is occasionally performed.

Many of the treatments for cervical spondylosis have not been subjected to rigorous, controlled trials. Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy" (Baron, M.E.).

Physical therapy may be effective for restoring range of motion, flexibility and core strengthening. Decompressive therapies (i.e. manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy and osteopathy cannot "cure" the degeneration, and some people view that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments and flexibility rehabilitation.

It has been argued, however, that the cause of spondylosis is simply old age, and that posture modification treatment is often practiced by those who have a financial interest (such as Worker's Compensation) in proving that it is caused by work conditions and poor physical habits. Understanding anatomy is the key to conservative management of spondylosis.

Potential surgical treatments include:

- Anterior cervical discectomy and fusion - A surgical treatment of nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine with a discectomy in order to stabilize the corresponding vertebrae.

- Laminoplasty - A surgical procedure relieve pressure on the spinal cord by cutting the lamina on both sides of the affected vertebrae (cutting through on one side and merely cutting a groove on the other) and then "swinging" the freed flap of bone open.

- Laminectomy - A surgical procedure in which the lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac.

Doctors often recommend physical therapy in order to strengthen the subscapularis muscle, and prescribe anti-inflammatory medications. For extreme cases, cortisone injections would be utilized.

Complete immobilization of the head and neck should be done as early as possible and before moving the patient. Immobilization should remain in place until movement of the head and neck is proven safe. "In the presence of severe head trauma, cervical fracture must be presumed until ruled out." Immobilization is imperative to minimize or prevent further spinal cord injury. The only exceptions are when there is imminent danger from an external cause, such as becoming trapped in a burning building.

Non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen, are contraindicated because they interfere with bone healing. Tylenol (acetaminophen) is a better option. Patients with cervical fractures will likely be prescribed medication for pain control.

In the long term, physical therapy will be given to build strength in the muscles of the neck to increase stability and better protect the cervical spine.

Collars, traction and surgery can be used to immobilize and stabilize the neck after a cervical fracture.

The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate, in which the notochord (a flexible rod of uniform composition) found in all chordates has been replaced by a segmented series of bones—vertebrae separated by intervertebral discs. The vertebral column houses the spinal canal, a cavity that encloses and protects the spinal cord.

There are about 50,000 species of animals that have a vertebral column. The human vertebral column is one of the most-studied examples.

Non specific thoracic spine pain is usually treated by one or a combination of the following:

- Exercise/Active and passive physical therapy

- Deep massage or massage therapy

- Ice and/or heat therapy

- Analgesics such as non-steroidal anti-inflammatory drugs

- Joint manipulation, as commonly performed by physical therapists, chiropractors or osteopathic physicians (D.O.).

- If there is a specific tender spot, then trigger point massage or injections can be helpful.

A painful vertebral compression fracture may be treated with pain medication and rest, or with vertebroplasty or kyphoplasty surgery. If the cause is thought to be osteoporosis, oral or intravenous bisphosphonates may be administered to reduce further fracture risk.

Surgery is usually only used if the non-surgical treatments have failed. Bone abnormalities may need surgical attention. The most common surgery for snapping scapula requires the surgeon to “take out a small piece of the upper corner of the scapula nearest to the spine.”

A cervical fracture, commonly called a broken neck, is a catastrophic fracture of any of the seven cervical vertebrae in the neck. Examples of common causes in humans are traffic collisions and diving into shallow water. Abnormal movement of neck bones or pieces of bone can cause a spinal cord injury resulting in loss of sensation, paralysis, or usually instant death.

Current surgical procedures used to treat spondylosis aim to alleviate the signs and symptoms of the disease by decreasing pressure in the spinal canal (decompression surgery) and/or by controlling spine movement (fusion surgery).

Decompression surgery: The vertebral column can be operated on from both an anterior and posterior approach. The approach varies depending on the site and cause of root compression. Commonly, osteophytes and portions of intervertebral disc are removed.

Fusion surgery: Performed when there is evidence of spinal instability or mal-alignment. Use of instrumentation (such as pedicle screws) in fusion surgeries varies across studies.

The effectiveness of non surgical treatments is unclear as they have not been well studied.

- Education about the course of the condition and how to relieve symptoms

- Medicines to relieve pain and inflammation, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs)

- Exercise, to maintain or achieve overall good health, aerobic exercise, such as riding a stationary bicycle, which allows for a forward lean, walking, or swimming can relieve symptoms

- Weight loss, to relieve symptoms and slow progression of the stenosis

- Physical therapy to support self-care. Also may give instructs on stretching and strength exercises that may lead to a decrease in pain and other symptoms.

- Lumbar epidural steroid or anesthetic injections have low quality evidence to support their use.

Treatment options are either surgical or non-surgical. Overall evidence is inconclusive whether non-surgical or surgical treatment is the better for lumbar spinal stenosis.

Congenital vertebral anomalies are a collection of malformations of the spine. Most around 85% are not clinically significant, but they can cause compression of the spinal cord by deforming the vertebral canal or causing instability. This condition occurs in the womb. Congenital vertebral anomalies include alterations of the shape and number of vertebrae.

If one’s symptoms are mild, treatments like Massage, Exercise, and Stress management will suffice in reducing pain and pressure, but those with more severe symptoms are told to undergo unique therapies based on their exact situation. These patients most likely will have their postures and spine alignment fixed, and/or treatments like electrical stimulation may be used to help in reducing pain and aid in flexibility. Medicine, epidural injections and surgeries are also implemented to treat such a disorder.

Wobbler disease is a catchall term referring to several possible malformations of the cervical vertebrae that cause an unsteady (wobbly) gait and weakness in dogs and horses. A number of different conditions of the cervical (neck) spinal column cause similar clinical signs. These conditions may include malformation of the vertebrae, intervertebral disc protrusion, and disease of the interspinal ligaments, ligamenta flava, and articular facets of the vertebrae. Wobbler disease is also known as cervical vertebral instability, cervical spondylomyelopathy (CSM), and cervical vertebral malformation (CVM). In dogs, the disease is most common in large breeds, especially Great Danes and Doberman Pinschers. In horses, it is not linked to a particular breed, though it is most often seen in tall, race-bred horses of Thoroughbred or Standardbred ancestry. It is most likely inherited to at least some extent in dogs and horses.

Wobbler disease is also found in horses, where it is often called wobbler's syndrome; it refers to several conditions beyond those listed above and is not by itself a singular disease. Wobblers is a broad term used to describe cervical disorders in the horse, including equine wobbles anemia and cervical vertebral myelopathy, spinal cord compression (sometimes referred to colloquially among horse owners as "cervical arthritis" due to the arthritis that accumulates in facets). It is also used as a catch-all phrase within the horse community to describe a neurological problem that causes limb proprioception issues or decreased performance in the horse that is suspected to be rooted in the neck. Most forms of wobblers disease have a root cause in cervical vertebral myelopathy (CVM), which causes inflammation and arthritis in the joint and is painful to affected horses. At this time it is believed to possibly be a congenital condition. Mounting evidence is growing that points to CVM and other cervical and vertebral disorders (like Kissing Spine) as hereditary and found in populations of specific families. .

Other forms, such as cervical arthritis and equine wobbles anemia, are concentrated in certain breeds and demonstrate possible hereditary factors. Horses with wobbler disease often exhibit ataxia (implying dysfunction of parts of the nervous system), show weakness in the hindquarters, or may knuckle over in their fetlocks, particularly in the rear. They also may show overall stiffness especially in the neck and back and may not move fluidly. A common ataxic symptom is the horse will list to one side behind. They also may demonstrate uneven strides with one leg intermittently shorter in step. Horses with wobblers or cervical anomalies can demonstrate difficult to diagnose lamenesses that come and go, and often are not resolved by veterinary blocks to the limbs. With advanced stages of the disease, affected horses are prone to falling due to extreme listing behind and often demonstrate difficulty getting up from lying down, or reluctance to lie down at all. While some cases are successfully treated with nutritional and medical management, surgery is also used. One method is the use of titanium baskets, placed to fuse the vertebrae, thereby preventing compression of the spinal cord. Some horses are able to return to work, with a few able to reach competitive levels. No complete cure for the condition is known. Famous horses known to have completed basket surgery include Seattle Slew. Seattle Slew underwent two basket surgeries and has sired multiple offspring that have cervical arthritis. He is one of many Thoroughbred stallions to have undergone basket surgery and still be used for stud.

Because wobbler's is the best known of the neurological conditions that affect horses, other, unrelated conditions, such as kissing spine, equine protozoal myeloencephalitis and cerebellar abiotrophy, are sometimes misdiagnosed as wobbler's, though the causes and symptoms differ.

Treatment involves fixation of the cervical spine to the skull base, or occipitocervical fusion, using paramedian rods and transpedicular screws with cross-links for stabilization. The patient is subsequently unable to rotate their head in the horizontal plane. If there is obstructive hydrocephalus, a pseudomeningocele can form, which is decompressed at the time of surgery.

Atlanto-occipital dislocation, orthopedic decapitation, or internal decapitation describes ligamentous separation of the spinal column from the skull base. It is possible for a human to survive such an injury; however, only 30% of cases do not result in immediate death.

Since there is a variety of classifications of winged scapula, there is also more than one type of treatment. Massage Therapy is an effective initial approach to relax the damaged muscles. In more severe cases, Physical Therapy can help by strengthening affected and surrounding muscles. Physical therapy constitutes treatment options if there is weakness of the glenohumeral joint muscles, but if the muscles do not contract clinically and symptoms continue to be severe for more than 3–6 months, surgery may be the next choice. Surgery by fixation of the scapula to the rib cage can be done for those with isolated scapular winging. Some options are neurolysis (chordotomy), intercostal nerve transfer, scapulothoracic fusion, arthrodesis (scapulodesis), or scapulothoracis fixation without arthrodesis (scapulopexy).

Upper back pain, also called middle back pain or thoracic back pain, is back pain that is felt in the region of the thoracic vertebrae, which are between the bottom of the neck and top of the lumbar spine. It has a number of potential causes, ranging from muscle strain to collapse of a vertebra or rare serious diseases. The upper spine is very strong and stable to support the weight of the upper body, as well as to anchor the rib cage which provides a cavity to allow the heart and lungs to function and protect them.

In most cases, the pain is likely to be self-limiting; in that case no diagnostic tests are required, and simple pain relief is sufficient. More severe and prolonged cases may require more specific pain management strategies and occasionally investigations for underlying medical diseases.

There is no specific treatment for rib fractures, but various supportive measures can be taken. In simple rib fractures, pain can lead to reduced movement and cough suppression; this can contribute to formation of secondary chest infection. Flail chest is a potentially life-threatening injury and will often require a period of assisted ventilation. Flail chest and first rib fractures are high-energy injuries and should prompt investigation of damage to underlying viscera (e.g., lung contusion) or remotely (e.g., cervical spine injury). Spontaneous fractures in athletes generally require a cessation of the cause, e.g., time off rowing, while maintaining cardiovascular fitness.

Treatment options for internal fixation/repair of rib fractures include:

- Judet and/or sanchez plates/struts are a metal plate with strips that bend around the rib and then is further secured with sutures.

- Synthes matrixrib fixation system has two options: a precontoured metal plate that uses screws to secure the plate to the rib; and/or an intramedullary splint which is tunneled into the rib and secured with a set screw.

- Anterior locking plates are metal plates that have holes for screws throughout the plate. The plate is positioned over the rib and screwed into the bone at the desired position. The plates may be bent to match the contour of the section.

- U-plates can also be used as they clamp on to the superior aspect of the ribs using locking screws.

Evidence for the treatment of thoracic outlet syndrome as of 2014 is poor.

A Cochrane review of low-intensity pulsed ultrasound to speed healing in newly broken bones found insufficient evidence to justify routine use. Other reviews have found tentative evidence of benefit. It may be an alternative to surgery for established nonunions.

Vitamin D supplements combined with additional calcium marginally reduces the risk of hip fractures and other types of fracture in older adults; however, vitamin D supplementation alone did not reduce the risk of fractures.