What is the anatomy relevant to cervical spinal nerve blocks for pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Answer

Answer

Cervical nerve roots (C1-C8) pass laterally through their respective foramina within the sulcus of each transverse process and exit at the level above the vertebral segment for which they are numbered. See the image below.

Anatomy of the cervical nerves (anterior view). Anatomy of the cervical nerves (anterior view).

The posterior tubercle of the tip of each transverse process is larger and more superficial, and therefore is easier to palpate than the nearby anterior tubercle. Ventral and dorsal divisions of each cervical nerve root join to form the dorsal root ganglion, which lies just posterior to the ascending vertebral artery.

Just lateral to the dorsal root ganglion, the posterior primary division or dorsal ramus passes posteriorly, dividing into a lateral muscular branch and a medial sensory branch. See the image below.

Anatomy of the cervical nerves in the neck (transv Anatomy of the cervical nerves in the neck (transverse section).

The anterior primary division or ventral ramus continues its anterolateral course, sending gray ramus communicantes to the nearby sympathetic ganglion situated adjacent to the anterolateral surface of the vertebral body. See the image below.

Anatomy of the cervical nerves (lateral view). Anatomy of the cervical nerves (lateral view).

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