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

Abstract

Narrative review article. To provide a comprehensive overview of the etiology, biomechanics, and clinical evaluation of cervical spinal deformity (CSD) for spine surgeons and related specialists. 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. This review synthesizes current literature on CSD biomechanics, epidemiology, and clinical evaluation, offering a systematic approach to understanding its causes and assessment. 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. 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 patients with cervical spinal deformity. Level V.