Spondylolisthesis C6 is less common than vertebral slippage at C5 or C7, but may occur in tandem with listhesis at one or both of these cervical spinal levels. Since the spinal cord exists in the neck, significant slippage of C6, or any of the cervical vertebrae, can have wide-ranging and potentially dire effects in extreme degrees of listhesis.
Vertebra C6 is near the end on the cervical lordotic curvature and is the second lowest vertebral bone in the neck. Since it is often wedged in place by the bones above and below in the descending curve, listhesis rarely occurs solely in C6, although technically it is possible. Most of the C6 listhesis we have seen occurs in combination with cervical 5 or cervical 7 and occasionally will affect all 3 bones together. In very rare circumstances, we have seen cases where C6 and C7 suffer anterolisthesis, while C5 suffers retrolisthesis concurrently.
This focused essay investigates some interesting facts about listhesis at cervical 6. We will examine the clinical expressions of C6 vertebral slippage and theorize why this bone is not often affected alone in the vast majority of cervical spondylolisthesis profiles.
Spondylolisthesis C6 Rare Causation
C6 resides on the descending aspect of the lordotic curvature in the cervical spine. The natural contour of the vertebral column at this location is prohibitive for listhesis development, compared to C5 or C7, so cervical 6 spondylolisthesis is actually rather rare.
When C6 is the sole affected vertebral bone, the cause is usually either a significant congenital defect, such as incomplete pars interarticularis formation or causation due to severe traumatic injury.
Although spinal deterioration markedly affects C6, it is rare for degenerative spondylolisthesis to occur to this level as a sole expression. However, we do see several cases of C6 listhesis that exists in combination with either C5 and/or C7 vertebral migration as being more common, despite the extreme rarity of multiple spondylolisthesis conditions.
Listhesis at C6 and C5 and/or C7
Multiple listhesis is the cervical spine occurs when 2 or more vertebral bones migrate together from their normal anatomical placement in the vertebral column. This occurrence is seldom seen and is usually the outcome of some very distinctive circumstances. However, when multiple listhesis does occur, it often involves C5, C6 and/or C7.
Multiple listhesis is not inherently more pathological than singular listhesis. In cases where the vertebrae migrate mildly to different degrees, the bottom vertebral bone may actually help to support the upper vertebra. However, when the grading of multiple listhesis reaches classification 3 or 4, additional slipped vertebrae generally mean potentially worse symptomatic potential and even more dramatic surgical interventions being required to rectify the condition.
Spondylolisthesis C6 Therapy
Minor and moderate cases of C6 listhesis are usually not symptomatic, as is typical for any type of vertebral migration issue. These conditions should be checked regularly by a specialist in spinal neurology to make sure that they are not progressing to pathological degrees. If some symptoms are present in these less significant classifications of listhesis, symptomatic and conservative care can generally be utilized to mitigate discomfort and increase overall functionality. We detail these practices in our spondylolisthesis treatment resource section.
When the degree of slippage reaches a pathological extent, such as in high grade 3 or grade 4 listhesis, surgery is most often employed to restore spinal alignment and address any neurological impingement that is occurring. Spinal fusion is the standard practice of this procedure and is well detailed in our dedicated resource section covering spondylolisthesis surgery.