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Is C1 lower than C2?

The C1 and C2 vertebrae are the first two vertebrae at the top of the cervical spine. Together they form the atlantoaxial joint, which is a pivot joint. The C1 sits atop and rotates around C2 below. More of the head's rotational range of motion comes from C1-C2 than any other cervical joint.

spine-health.com - The C1-C2 Vertebrae and Spinal Segment - Spine-health
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The C1 and C2 vertebrae are the first two vertebrae at the top of the cervical spine. Together they form the atlantoaxial joint, which is a pivot joint. The C1 sits atop and rotates around C2 below. More of the head’s rotational range of motion comes from C1-C2 than any other cervical joint. Mead LB, Millhouse PW, Krystal J, Vaccaro AR. C1 fractures: a review of diagnoses, management options, and outcomes. Curr Rev Musculoskelet Med. 2016;9(3):255-62. The C1 and C2 vertebrae are the first two vertebrae of the cervical spine. They are also called the atlas and axis vertebrae. Watch: Spinal Motion Segment: C1-C2 (Atlantoaxial Joint) Animation While C1-C2 is relatively sturdy and resistant to injury, it can become quite painful and problematic due to trauma or degenerative conditions. These problems may also affect the spinal nerves, vertebral artery, and/or the spinal cord at the at the C2 level. The spinal cord is protected by the C1-C2 vertebrae in the upper cervical area. These vertebrae have several small and large foramens. The spinal cord passes through the large, centrally placed vertebral foramen. The smaller foramens facilitate the passage of blood vessels around the spine. An injury to this nerve can cause problems in any part of its dermatome and/or myotome.

The C1-C2 vertebrae and spinal segment include the following structures:

Schleicher P, Scholz M, Pingel A, Kandziora F. Traumatic Spondylolisthesis of the Axis Vertebra in Adults. Global Spine J. 2015;5(4):346-58. Schleicher P, Scholz M, Pingel A, Kandziora F. Traumatic Spondylolisthesis of the Axis Vertebra in Adults. Global Spine J. 2015;5(4):346-58. Problems at the C1-C2 vertebral levels may affect the vertebrae, the C2 spinal nerve, and/or the spinal cord. A few examples of problems at this cervical level include: Depending on the type of injury, associated symptoms may occur in the upper neck and/or in other areas of the body.

Common Symptoms and Signs Stemming from C1-C2

Vertebral pain at C1-C2 can range anywhere from a dull ache to a sharp, burning pain in the neck. C1-C2 pain may either last for a short while or become chronic. If a C2 nerve root becomes inflamed or injured, additional symptoms may include:

Radiating pain up to the back and/or top of the head

Pain in the temple and/or behind the eyes and/or ears

Neck-tongue syndrome resulting in neck and/or head pain with numbness or abnormal sensation on one side of the tongue

Sensitivity to light

Fatigue

Dizziness

Nausea

See Neck Pain Symptoms

Symptoms of C2 nerve injuries are usually aggravated while lying down. There may be increased pain at night, causing disturbed sleep.

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