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A Narrative Review of Cervical Spinal Deformity: Etiologies, Radiographic Parameters, and Clinical Assessment

Srikanth N. Divi, Tyler M. Compton, Daniel E. Herrera, Wellington K. Hsu, Alpesh A. Patel

Clinical Spine Surgery, 2025

1 citation

Abstract

STUDY DESIGN

Narrative review article.

OBJECTIVE

To provide a comprehensive overview of the etiology, biomechanics, and clinical evaluation of cervical spinal deformity (CSD) for spine surgeons and related specialists.

SUMMARY OF BACKGROUND DATA

CSD includes a heterogeneous group of conditions marked by abnormal cervical alignment, most often kyphosis or scoliosis. These deformities can significantly impair quality of life due to pain, neurological deficits, and disability. A clear understanding of biomechanical alterations, radiographic parameters, and underlying etiologies is critical for effective diagnosis and management.

METHODS

This review synthesizes current literature on CSD biomechanics, epidemiology, and clinical evaluation, offering a systematic approach to understanding its causes and assessment.

RESULTS

We discuss the biomechanics of the cervical spine, emphasizing the T1 slope and radiographic markers such as the C2-7 sagittal vertical axis. CSD etiologies include degenerative, iatrogenic, inflammatory, traumatic, congenital, neuromuscular, infectious, and oncologic causes. We outline key physical exam findings, imaging techniques, and classification systems that inform clinical decision-making.

CONCLUSIONS

CSD is a multifactorial condition that demands individualized evaluation and treatment. Understanding the pathophysiology and natural history of each cause is essential. Careful clinical and radiographic assessment is vital for optimizing outcomes in…

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