There are multiple pain generators of the cervical spine and detecting degenerative changes and their extent are important in clinical management.
The normal cervical spine has a lordotic curvature.
The anterior and posterior cortices of the vertebral bodies should align with the adjacent bodies. Anterior alignment of a body relative to the body caudal to it is retrolisthesis.
In contrast, posterior alignment of the body relative to the body caudal to it is anterolisthesis. Flexion and extension radiographs can depict abnormal motion between vertebral bodies.
Disc degeneration is detected radiographically by height loss and endplate osteophyte formation.
- Anterolisthesis of C3 on C4 and C4 on C5. Vertebral body heights are maintained.
- Multilevel degenerative changes characterized by disc space loss, uncovertebral joint degeneration, and facet arthropathy, most pronounced at C6-C7.
- The prevertebral soft tissues are within normal limits.
- Multilevel degenerative changes, most pronounced at C6-C7.
Degenerated facet joints can be detected by subchondral sclerosis, osteophyte formation, and joint space narrowing.
Radiographically normal facets depicted on the left and facet arthropathy depicted on the right.