[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/) › C4–C5 disc [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # C4–C5 disc The C4-C5 disc is the cushion between the C4 and C5 neck vertebrae; it absorbs load and lets the neck bend and turn. Official name: C4-C5 [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=disc_c4_c5&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The cushion between C4 and C5: 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 - C5 root picture: weak shoulder abduction (deltoid) and elbow flexion (biceps), a reduced biceps reflex and numbness over the outer upper arm - C5 weakness can look like a rotator cuff problem; pain that changes with neck movement rather than shoulder movement points to the root - C5 palsy is a known complication of cervical decompression: deltoid and biceps weakness appearing hours to days after surgery, often recovering over months ## Key facts **Where** Between C4 and C5 bodies; taller in front (cervical lordosis); flanked by uncovertebral joints **Attaches** Annulus fibrosus anchored to the [endplates](https://durgical.com/en/anatomy/vertebral-endplates/) and ring apophyses of C4 and C5; anterior and posterior longitudinal ligaments **Function** Absorbs and spreads load; posterolateral herniation usually compresses the C5 root ## Relations **In front** [Longus colli](https://durgical.com/en/anatomy/longus-colli-muscle/), then the [esophagus](https://durgical.com/en/anatomy/esophagus-abdominal-part/) and the larynx behind the [thyroid cartilage](https://durgical.com/en/anatomy/thyroid-cartilage/); the [carotid arteries](https://durgical.com/en/anatomy/common-carotid-artery/) and [internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/) lie anterolaterally in the [carotid sheath](https://durgical.com/en/anatomy/carotid-sheath/) **Behind** [Posterior longitudinal ligament](https://durgical.com/en/anatomy/posterior-longitudinal-ligament/), the dural sac and the [spinal cord](https://durgical.com/en/anatomy/spinal-cord/) at the start of its cervical enlargement **Lateral** Uncovertebral joints, the [vertebral artery](https://durgical.com/en/anatomy/vertebral-artery/) and the [C5 nerve root](https://durgical.com/en/anatomy/c5-spine-and-pelvis/) in the C4–C5 foramen ## How to find it From the front, about the level of the thyroid cartilage (Adam's apple). As at every cervical level, the surgeon confirms it with a marker needle and a lateral X-ray before removing the disc. ## Examination - Shoulder abduction and elbow flexion against resistance: weakness of the deltoid and biceps points to the C5 nerve root - Biceps reflex: reduced on the affected side with C5 (and C6) root compression ## On imaging Radiographs show narrowing and spurs; oblique views and CT show uncovertebral spurs encroaching on the C4–C5 foramen, where the C5 root exits. MRI is chosen for radiculopathy or myelopathy: axial T2 separates a soft disc in the foramen from bony narrowing, and sagittal images show cord compression. CT myelography is used when MRI is not possible. ## 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 - Differentials for C5 weakness: rotator cuff tear, a [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/) stretch injury («burner» in contact sports) and neuralgic amyotrophy (Parsonage–Turner syndrome) - A large central herniation at C4–C5 compresses the cord: lower motor neuron signs at the level (C5) with upper motor neuron signs below it, in arms and legs ## Related conditions - [Degenerative cervical myelopathy](https://durgical.com/en/conditions/degenerative-cervical-myelopathy/) ## Test yourself Think of the answer, then tap the question to see it. ## What is the clinical picture of the C5 root compressed by a C4–C5 disc herniation? Weak shoulder abduction (deltoid) and elbow flexion (biceps), a reduced biceps reflex and numbness over the outer upper arm. ## What is C5 palsy after cervical decompression? Deltoid and biceps weakness appearing hours to days after surgery, often recovering over months. ## How can C5 radiculopathy from a C4–C5 disc be told apart from a rotator cuff problem? Pain that changes with neck movement rather than shoulder movement points to the nerve root. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/c4-c5/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** discus intervertebralis C4-C5 TA2 1684 **Official Spanish (DeCS)** Disco C4-C5 DeCS D007403 **English (TA2)** C4-C5 **Also called** fibrous ring · fibrocartilago intervertebralis ## Related - [C4–C5 nucleus](https://durgical.com/en/anatomy/c4-c5-spine-and-pelvis/) - [C4 vertebra](https://durgical.com/en/anatomy/c4/) - [C5 vertebra](https://durgical.com/en/anatomy/c5/) - [C5 nerve root](https://durgical.com/en/anatomy/c5-spine-and-pelvis/) 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/c4-c5/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/c4-c5/