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.

The presence of a cervical rib can cause a form of thoracic outlet syndrome due to compression of the lower trunk of the brachial plexus or subclavian artery. These structures become encroached upon by the cervical rib and scalene muscles.

Compression of the brachial plexus may be identified by weakness of the muscles around the muscles in the hand, near the base of the thumb. Compression of the subclavian artery is often diagnosed by finding a positive Adson's sign on examination, where the radial pulse in the arm is lost during abduction and external rotation of the shoulder. A positive Adson's sign is non-specific for the presence of a cervical rib however, as many individuals without a cervical rib will have a positive test.

Hemivertebrae are wedge-shaped vertebrae and therefore can cause an angle in the spine (such as kyphosis, scoliosis, and lordosis).

Among the congenital vertebral anomalies, hemivertebrae are the most likely to cause neurologic problems. The most common location is the midthoracic vertebrae, especially the eighth (T8). Neurologic signs result from severe angulation of the spine, narrowing of the spinal canal, instability of the spine, and luxation or fracture of the vertebrae. Signs include rear limb weakness or paralysis, urinary or fecal incontinence, and spinal pain. Most cases of hemivertebrae have no or mild symptoms, so treatment is usually conservative. Severe cases may respond to surgical spinal cord decompression and vertebral stabilization.

Associations

Recognised associations are many and include:

Aicardi syndrome,

cleidocranial dysostosis,

gastroschisis 3,

Gorlin syndrome,

fetal pyelectasis 3,

Jarcho-Levin syndrome,

OEIS complex,

VACTERL association.

The probable cause of hemivertebrae is a lack of blood supply causing part of the vertebrae not to form.

Hemivertebrae in dogs are most common in the tail, resulting in a screw shape.

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.

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.

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.

The thoracic spine begins at the base of the neck and extends to the middle of the trunk. Any pain in this area is considered "middle back pain".

The exact symptoms associated with middle back pain will depend upon the underlying cause. Most middle back pain is not serious in nature. However, it does tend to have more serious pathology associated with it than pain in the neck or low back. Symptoms can include pain, either locally near the spine or referred along area the corresponding nerve dermatome. Symptoms can also include numbness or pins and needles when nerve irritation or compression is involved. Weakness in the legs or loss of bowel or bladder control in the presence of thoracic spine pain can indicate spinal cord compression and should be investigated.

Including the symptoms listed above, clinical presentations of "wobblers" can also include neck pain and stiffness, difficulty tracking up or gait abnormalities, decreased performance, intermittent or swapping lameness particularly in diagonal pairs, forelimb lameness, abnormal head and neck posture, defensiveness or change in behavior, and abnormal sweat patterns.

If not treated right away, there are many consequences and pains various cervical spine disorders can cause.

- Neck pains Pains in the neck area tend to be tenacious and persistent and most muscles in the cervical spinal region tighten causing for discomfort.

- Headaches Headaches are further triggered through the stiffness of neck muscles, which pull at their attachment to the skull. These headaches are recurrent in nature and start from the base of the skull and emanate upwards; they can be painful or mild.

- Arm pains Muscular spasms within the arm are further common symptoms in which such spasms are seen right above the collarbones and pressure is placed on the Brachial plexus causing arms to feel heavy and ache.

- Difficulty walking Hardships arise with cervical spinal injuries when issues with walking, balancing, and posture are affected all due to the spinal cord being compressed resulting in Myelopathy.

- Those with extremely severe outcomes may result in:Impairment

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.

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.

Spondylosis is a broad term meaning degeneration of the spinal column from any cause. In the more narrow sense it refers to spinal osteoarthrosis, the age-related wear and tear of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints (facet syndrome). If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.

When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel or bladder control. The patient may experience shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis. The term is from Ancient Greek σπόνδυλος "spóndylos", "a vertebra", in plural "vertebrae – the backbone".

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.

Excessive or abnormal spinal curvature is classed as a spinal disease or dorsopathy and includes the following abnormal curvatures:

- Kyphosis is an exaggerated kyphotic (concave) curvature in the thoracic region, also called hyperkyphosis. This produces the so-called "humpback" or "dowager's hump", a condition commonly resulting from osteoporosis.

- Lordosis as an exaggerated lordotic (convex) curvature of the lumbar region, is known as lumbar hyperlordosis and also as "swayback". Temporary lordosis is common during pregnancy.

- Scoliosis, lateral curvature, is the most common abnormal curvature, occurring in 0.5% of the population. It is more common among females and may result from unequal growth of the two sides of one or more vertebrae, so that they do not fuse properly. It can also be caused by pulmonary atelectasis (partial or complete deflation of one or more lobes of the lungs) as observed in asthma or pneumothorax.

- Kyphoscoliosis, a combination of kyphosis and scoliosis.

It is through upper frontal chest discomfort (also known as cervical angina) and scapular pains which signs of cervical spine disorders are shown. In 1937 a man named Oille was the first to state that these chest pains originated from the cervical nerve root. This new outlook helped shed light on exactly what signs indicated the beginning of these ailments for those suffering from cervical spine disorders. It is now recognized that these patients feel pain, numbness, discomfort, and weakness along with neurological symptoms.

- Numbness Numbness occurs when one develops a “pinched” nerve not allowing for the flow of electrical charges, which may result in the death of the nerve fiber.

- Weakness An individual becomes weak due to the compression of nerves encompassing cervical spine disorders, thus resulting in the inability to move or use arms. Those who suffer from such symptoms should seek medical treatment as soon as possible.

Cervical spinal stenosis is a bone disease involving the narrowing of the spinal canal at the level of the neck. It is frequently due to chronic degeneration, but may also be congenital. Treatment is frequently surgical.

Cervical spinal stenosis is one of the most common forms of spinal stenosis, along with lumbar spinal stenosis (which occurs at the level of the lower back instead of in the neck). Thoracic spinal stenosis, at the level of the mid-back, is much less common. Cervical spinal stenosis can be far more dangerous by compressing the spinal cord. Cervical canal stenosis may lead to serious symptoms such as major body weakness and paralysis. Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck. It is frequently due to chronic degeneration, but may also be congenital or traumatic. Treatment frequently is surgical.

The injury is a result of disruption of the stabilizing ligaments between the occiput, or posterior skull base, and the C1 vertebral body, otherwise known as the atlas. The diagnosis is usually suspected by history and physical exam, but confirmed by imaging, typically by CT due to its faster speed in the acute trauma setting, although MRI can also help with assessment in equivocal cases. The treatment is initial stabilization with a cervical spine collar, and then surgical intervention in cases in which reversal of paralysis is possible. The most common mechanism of injury is high-speed motor vehicle accidents. The injury is more likely in children due to the large size of their heads relative to their bodies, and more horizontal orientation of the occipital condyles. It represents <1% of all cervical spine injuries.

Any of the factors below may cause the spaces in the spine to narrow.

- Spinal ligaments can thicken ("ligamenta flava")

- Bone spurs develop on the bone and into the spinal canal or foraminal openings

- Intervertebral discs may bulge or herniate into the canal or foraminal openings

- Degenerative disc disease causes narrowing of the spaces

- Facet joints break down

- Compression fractures of the spine, which are common in osteoporosis

- Cysts form on the facet joints causing compression of the spinal sac of nerves (thecal sac)

There are multiple techniques used in the diagnosis of spondylosis, these are;

- Cervical Compression Test, a variant of Spurling's test, is performed by laterally flexing the patient's head and placing downward pressure on it. Neck or shoulder pain on the ipsilateral side (i.e. the side to which the head is flexed) indicates a positive result for this test. However it should be noted that a positive test result is not necessarily a positive result for spondylosis and as such additional testing is required.

- Lhermitte sign: feeling of electrical shock with patient neck flexion

- Reduced range of motion of the neck, the most frequent objective finding on physical examination

- MRI and CT scans are helpful for pain diagnosis but generally are not definitive and must be considered together with physical examinations and history.

Snapping Scapula Syndrome, also known as scapulocostal syndrome or scapulothoracic syndrome, is described by a “grating, grinding, popping or snapping sensation of the scapula onto the back side of the ribs or thoracic area of the spine” (Hauser). Disruption of the normal scapulothoracic mechanics causes this problem. The most common cases are found in young, active patients who tend to excessively use the overhead or throwing motion.

Grynfeltt-Lesshaft hernia is a herniation of abdominal contents through the back, specifically through the superior lumbar triangle, which is defined by the quadratus lumborum muscle, twelfth rib, and internal oblique muscle.

Scoliosis is a common spinal disease in which the spine has a curvature usually in the shape of the letter "C" or "S". This is most common in girls, but there is no specific cause for scoliosis. Only a few symptoms occur for one with this disease, which include feeling tired in the spinal region or backaches. Generally, if the hips or shoulders are uneven, or if the spine curves, it is due to scoliosis and should be seen by a doctor.

Lumbar spinal stenosis is classified as a narrowing of the spinal canal in the lumbar region of the vertebrae. This may lead to compression of the nerve root of the spinal cord and result in pain of the lower back and lower extremities. Other symptoms include impaired walking and a slightly stooped posture due to loss of disc height and bulging of the disc. Lumbar spinal stenosis is very prevalent with 9.3% of the general population producing symptoms and the number is continuing to rise in patients older than 60. It's generally an indication for spinal surgery in patients older than 65 years of age.

DISH can present with spinal stiffness on forward flexion/back extension, or with mild back pain. It is symptomatic for thoracic spinal pain in approximately 80% of patients. Back pain or stiffness is worse in the morning in almost two-thirds of patients. It may also be asymptomatic and discovered as an incidental radiological abnormality. Dysphagia from cervical spine osteophyte impingement of esophagus is reported in some cases. Similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest, ischial tuberosity, trochanters of the hip, tibial tuberosities, patellae, and bones of the hands and/or feet.

The most common forms are cervical spinal stenosis, which are at the level of the neck, and lumbar spinal stenosis, at the level of the lower back. Thoracic spinal stenosis, at the level of the mid-back, is much less common.

In lumbar stenosis, the spinal nerve roots in the lower back are compressed which can lead to symptoms of sciatica (tingling, weakness, or numbness that radiates from the low back and into the buttocks and legs).

Cervical spinal stenosis can be far more dangerous by compressing the spinal cord. Cervical canal stenosis may lead to myelopathy, a serious conditions causing symptoms including major body weakness and paralysis. Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck. It is frequently due to chronic degeneration, but may also be congenital or traumatic. Treatment frequently is surgical.