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Fig. 31.1. Lateral X-rays of a normal (a) and degenerate (b) cervical spine. The normal cervical spine has a gentle lordotic curvature, with a neutral axis located along the posterior aspects of the vertebral bodies. Advanced degenerative changes b are seen in the mid-cervical spine. The cervical lordosis is lost and there is a kyphotic deformity from C3 to C5. There are advanced degenerative changes affecting disks, with significant loss of disk space height and sclerotic changes involving the vertebral bodies. Osteophytes are present both anteriorly and posteriorly at C4-C5 and C5-C6.

Fig. 31.1. Lateral X-rays of a normal (a) and degenerate (b) cervical spine. The normal cervical spine has a gentle lordotic curvature, with a neutral axis located along the posterior aspects of the vertebral bodies. Advanced degenerative changes b are seen in the mid-cervical spine. The cervical lordosis is lost and there is a kyphotic deformity from C3 to C5. There are advanced degenerative changes affecting disks, with significant loss of disk space height and sclerotic changes involving the vertebral bodies. Osteophytes are present both anteriorly and posteriorly at C4-C5 and C5-C6.

a condition is quite variable and can be extreme. A patient with DISH has an exuberant accumulation of anterior osteophytes and calcification along the vertebral bodies (Fig. 31.3). In addition to the distinct changes of each of these conditions, the patients have advanced degenerative changes involving the disk spaces. OPLL is more commonly seen in the Asian population. No specific cause has been determined. DISH is somewhat more common in African-American males.

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