In the appendicular skeleton, one is mostly concerned with the diarthrodial synovial joints. While this type of joint is also found in the axial skeleton (the facet (a.k.a. aphophyseal) joints and portions of the sacroiliac joints), there are also many amphiarthrodial joints which are not synovial (the intervertebral disc joints). However, there are several structures in the intervertebral disc joint which are analogous to structures found in a true synovial joint. The cartilaginous endplate, the annulus fibrosus, and the nucleus pulposus are analogous to the articular cartilage, the joint capsule and the synovial fluid of the synovial joint.

Cervical disc disorders encountered in physiatric practice include herniated nucleus pulposus (HNP), degenerative disc disease (DDD), and internal disc disruption (IDD). HNP implies extension of disc material beyond the posterior margin of the vertebral body. Most of the herniation is made up of the annulus fibrosus. DDD involves degenerative annular tears, loss of disc height, and nuclear degradation. IDD describes annular fissuring of the disc without external disc deformation. Cervical radiculopathy can result from nerve root injury in the presence of disc herniation or stenosis, most commonly foraminal stenosis, leading to sensory, motor, or reflex abnormalities in the affected nerve root distribution. Understanding cervical disc disease requires basic knowledge of anatomy and biomechanics. The intervertebral disc absorbs shock, accommodates movement, provides support, and separates vertebral bodies to lend height to intervertebral foramina. The disc consists of an eccentrically located nucleus pulposus and a surrounding annulus fibrosus separating each segmental level between the C2-T1 vertebrae. No disc exists between C1 and C2, and only ligaments and joint capsules resist excessive motion. Disc degeneration and/or herniation can injure the spinal cord or nerve roots and result in stenosis and/or myofascial pain.
Synonyms and related keywords: annular tear, degenerative disc disease, DDD, disc degeneration, disc extrusion, disc herniation, disc protrusion, disc sequestration, discogenic pain, herniated nucleus pulposus, HNP, inflammatory radiculopathy, internal disc disruption, IDD, intervertebral disc herniation, radicular pain, radiculitis, radiculopathy, degenerative annular tears, cervical radiculopathy, nerve root injury, disc stenosis, myofascial pain, cervical disc disorder, central cord syndrome, CCS, spondylosis, neck pain, shoulder pain, Brown-Séquard syndrome, chemical radiculitis, nerve root compression, vertebral sclerosis, osteophytic formation, whiplash, dynatome, Spurling maneuver, abduction sign, repetitive cervical stress, smoking, atherosclerosis, cervical flexion injury, cervical rotation injury
Furman, Simon & Falco 2007

Cervical radiculopathy is a dysfunction of a nerve root of the cervical spine. The seventh (C7; 60%) and sixth (C6; 25%) cervical nerve roots are the most commonly affected. In the younger population, cervical radiculopathy is a result of a disk herniation or an acute injury causing foraminal impingement of an exiting nerve. In the older patient, cervical radiculopathy often is a result of foraminal narrowing from osteophyte formation. Factors associated with increased risk include heavy manual labor requiring lifting of more than 25 pounds, smoking, and driving or operating vibrating equipment. The purpose of this article is to provide information on the presentation, evaluation, differential diagnosis, and treatment of cervical radiculopathy.
Synonyms and related keywords: burner syndrome, pinched nerve
Author: Gerard A Malanga, MD 2005

Cervical spondylosis is a common degenerative condition of the cervical spine. It is most likely caused by age-related changes in the intervertebral disks. Clinically, several syndromes, both overlapping and distinct, are seen. These include neck and shoulder pain, suboccipital pain and headache, radicular symptoms, and cervical spondylotic myelopathy (CSM). As disk degeneration occurs, mechanical stresses result in osteophytic bars, which form along the ventral aspect of the spinal canal.
Synonyms and related keywords: cervical degenerative joint disease, cervical degenerative disk disease, cervical osteoarthritis, cervical spondylotic myelopathy, CSM, disk degeneration, degenerative cervical disease, osteophytic bars, cervical radiculopathy, neck pain, shoulder pain, cervicalgia, chronic suboccipital headache, paresthesias, pseudoangina, breast pain, nontraumatic paraparesis, nontraumatic tetraparesis, numbness, clumsy hands, loss of manual dexterity, difficulty with writing, central cord syndrome, Tinel sign, Spurling sign, Babinski sign, Hoffman sign, pectoralis muscle reflex, spastic gait, Lhermitte sign
Baron & Young 2007

Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck (in the form of, for example, disk herniation and spur formation), as well as the contents of the spinal canal (nerve roots and/or spinal cord). Some authors also include the degenerative changes in the facet joints, longitudinal ligaments, and ligamentum flavum.
Synonyms and related keywords: cervical osteoarthritis, degenerative arthropathy of the cervical spine, facet joints, longitudinal ligaments, ligamentum flavum, chronic cervical degeneration, cervical disk degeneration, cervical disc degeneration, disk herniation, spur formation, nerve root compression, progressive spinal cord compression, foraminal stenoses, foraminal stenosis, spinal canal stenosis, chronic neck pain, diminished cervical range of motion, cervical spondylotic myelopathy, quadriparesis, sphincteric dysfunction, chronic suboccipital headache, cervical radiculopathy, acute herniated disk, cervical intervertebral disk degeneration, transverse lesion syndrome, motor syndrome, central cord syndrome, Brown-Séquard syndrome, brachialgia, tandem spinal stenosis, neurogenic claudication, gait abnormality, dysphagia, vertebrobasilar insufficiency, elevated hemidiaphragm, Spurling sign, Lhermitte sign, Hoffman sign, degenerative disk disease, DDD
Al-Shatoury, Galhom & Wagner 2007

Definition: Outgrowth of immature bony processes from the vertebrae, reflecting the presence of degenerative disease and calcification. It includes cervical and lumbar spondylosis.
Synonym(s): Barre-Lieou Syndrome / Osteophytosis, Spinal / Posterior Cervical Sympathetic Syndrome / Spondylosis /
Narrow term(s): Hyperostosis, Diffuse Idiopathic Skeletal
Broader term(s) : Spinal Diseases - Bone Diseases - Musculoskeletal Diseases - Osteoarthritis - Arthritis - Joint Diseases