Interspinous ligament neck pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The cervical spine consists of 7 block-shaped bones called vertebrae (and numbered C1 to C7).

Each vertebrae of the vertebral column has bony areas for the attachment of muscles. The spinal column protects the spinal cord and exiting nerves.

The neck vertebrae have two major functions:

•To bear the weight of the head

•To protect the spinal cord or spinal nerve roots inside the spinal column

There are two major parts to each vertebra:

•The vertebral body is the front of the vertebrae. It is shaped like a cylinder and is higher in front than in back.

•The vertebral arch is the back of the vertebrae.

At the center of each vertebra is a hole. Altogether, the central hole of each vertebra forms the spinal canal through which the spinal cord and spinal nerve roots pass.

Each vertebra has bony projections called "processes" that are sites for the attachment of ligaments and muscles that help stabilize and move the spine.

The projections on either side of each vertebra are called transverse processes, and the ones at the back are called the spinous processes. The transverse processes are long and slender; the spinous processes are broad and thick.

The back portion of the vertebrae, behind the transverse processes, consists of an area of bone called the laminae.

On the back part of the vertebrae are joints connecting one vertebra to the next. These are the facet joints and they are important for movement between each vertebra and for movements of the vertebral column as a unit.

Between each vertebra are cushions, called discs. Each disc has a soft jelly-like center called the nucleus pulposus, which is surrounded by a tough fibrous outer envelope called the annulus fibrosis.

In the neck there are a series of ligaments that are important to the stability of the vertebral column.

•The interspinous ligament runs from the base of one spinous process (the projections at the back of each vertebra) to another.

•Intertransverse ligaments and supraspinous ligaments run along the tips of the spinous processes.

In the cervical vertebrae, the interspinous ligaments at C5-7 are prone to tear following neck injuries. The interspinous ligaments are slack when the head and neck are in the upright or balanced position.

During hyperextension of the head (when the head is bent backward), the ligaments slacken even more and the tips of the spinous process may touch one another.

In hyperflexion (head is bent forward,) the cervical interspinous ligaments are tightened and they are vulnerable to tears usually at the inferior and superior aspects of the cervical tips of the spinous processes.

An example of an injury to the interspinous ligaments is a rear-end automobile whiplash incident.

The tips of the spinous processes are mixed with the fibers of the ligamentum nuchae (long ligaments of the neck), which is attached to the occipital protuberance (middle of the base of the skull).

The ligamentum nuchae also blends with the trapezius muscle. Thus, cervical soft tissue injuries may produce symptoms in the arms, wrists and hands, and also pain and tightness of the head and shoulder muscles.

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