[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › C2–C3 disc [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # C2–C3 disc The C2-C3 disc is the cushion between the C2 and C3 neck vertebrae; it absorbs load and lets the neck bend and turn. Official name: C2-C3 [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=disc_c2_c3&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The cushion between C2 and C3: a tough outer ring of fibres (annulus fibrosus) around a soft centre. ## What it does Absorbs load and lets the neck bend and turn. [C5-C6](https://durgical.com/en/anatomy/c5-c6/) is the most mobile and most worn neck level. ## Key points - Herniation at C2–C3 is uncommon; the C3 root has no muscle or reflex that tests it reliably, so the picture is mostly upper-neck pain and numbness - It sits beside the C2–C3 facet joint, a classic source of headache arising from the neck (cervicogenic headache) through the third occipital nerve - In a hangman's fracture of the axis (C2), angulation or forward slip of C2 on C3 means the C2–C3 disc and ligaments are torn, which makes the injury unstable ## Key facts **Where** Between C2 and C3 bodies; first disc of the [spine](https://durgical.com/en/anatomy/region/spine/) (none at C0–C1 or C1–C2) **Attaches** Annulus fibrosus anchored to the [endplates](https://durgical.com/en/anatomy/vertebral-endplates/) and ring apophyses of C2 and C3; anterior and posterior longitudinal ligaments **Function** Absorbs and spreads load; posterolateral herniation usually compresses the C3 root ## Relations **In front** Prevertebral fascia and the [longus colli](https://durgical.com/en/anatomy/longus-colli-muscle/), then the retropharyngeal space and the [pharynx](https://durgical.com/en/anatomy/pharynx/); from the front the level lies near the angle of the [mandible](https://durgical.com/en/anatomy/mandible/) and just above the hyoid **Behind** [Posterior longitudinal ligament](https://durgical.com/en/anatomy/posterior-longitudinal-ligament/), which continues upward as the tectorial membrane, the epidural space, the dural sac and the upper cervical [spinal cord](https://durgical.com/en/anatomy/spinal-cord/) **Lateral** Uncovertebral joints and, further out, the [vertebral artery](https://durgical.com/en/anatomy/vertebral-artery/) in the transverse foramina of the [axis (C2)](https://durgical.com/en/anatomy/axis/) and the [C3 vertebra](https://durgical.com/en/anatomy/cervical-vertebrae/); the C3 root leaves through the foramen at this level **Above** Body of the axis (C2), with the dens rising from it ## How to find it From behind, the C2 spinous process is the first large bony point felt in the midline below the occiput; the C2–C3 disc lies just below it. From the front it is roughly level with the angle of the mandible. In surgery the level is confirmed on a lateral X-ray. ## On imaging Lateral X-ray in children: a slight forward shift of C2 on C3 is often normal (pseudosubluxation, which can also affect C3–C4); a line drawn along the front of the spinous processes of C1 to C3 (posterior cervical or Swischuk line) helps tell it from an injury. ## Common problems - Herniation pressing on the [C6 nerve root](https://durgical.com/en/anatomy/c6-spine-and-pelvis/): neck pain and pain, numbness or weakness down the arm into the thumb side of the hand. - Degeneration with bone spurs, which can narrow the canal and press on the spinal cord (myelopathy: clumsy hands, unsteady walking). ## How it is diagnosed Exam of arm strength, reflexes and feeling, plus signs of cord pressure. MRI shows the disc, nerve roots and cord. ## Treatment - Most arm pain from a disc improves with time, physical therapy, medicine and sometimes an injection. - Lasting arm pain, weakness or cord pressure: anterior cervical discectomy and fusion (ACDF), or disc replacement in selected patients. ## Clinical notes - Anterior surgery at C2–C3 is among the hardest in the neck: the mandible limits the view and the hypoglossal and superior laryngeal nerves cross the high exposure - Pain referred to the back of the head and the upper neck from this segment is easily mistaken for a primary headache - Pain from the C2–C3 facet joint travels through the third occipital nerve; a block of that nerve that briefly removes the headache supports the diagnosis and can lead to radiofrequency denervation ## Anatomical variants - Congenital fusion of C2 and C3 (block vertebra) is the most common site of congenital cervical fusion, as in Klippel–Feil syndrome; no disc forms and the segments next to it wear faster ## Development In young children the upper cervical ligaments are lax and the facets shallow, so C2 normally glides forward on C3 in flexion (pseudosubluxation, until about age 8); a line along the backs of the C1–C3 arches (Swischuk line) helps tell it from a true injury. ## Test yourself Think of the answer, then tap the question to see it. ## Which joint beside the C2–C3 disc is a classic source of cervicogenic headache, and through which nerve? The C2–C3 facet joint, through the third occipital nerve. ## In a hangman's fracture, what does angulation or forward slip of C2 on C3 mean for the C2–C3 disc? The C2–C3 disc and ligaments are torn, which makes the injury unstable. ## What is the most common site of congenital cervical fusion, as in Klippel–Feil syndrome? C2–C3: no C2–C3 disc forms, and the segments next to the block wear faster. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/c2-c3/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** discus intervertebralis C2-C3 TA2 1684 **Official Spanish (DeCS)** Disco C2-C3 DeCS D007403 **English (TA2)** C2-C3 **Also called** fibrous ring · fibrocartilago intervertebralis ## Related - [C2–C3 nucleus](https://durgical.com/en/anatomy/c2-c3-spine-and-pelvis/) - [Axis (C2)](https://durgical.com/en/anatomy/axis/) - [C3 vertebra](https://durgical.com/en/anatomy/cervical-vertebrae/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=7567); [Anatomy, Back, Intervertebral Discs](https://www.ncbi.nlm.nih.gov/books/NBK470583/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/c2-c3/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/c2-c3/