Adult Cervical Spine Disorders: A Comprehensive Etiological, Imaging-Based, Biomechanical, Neurological, Surgical, and Host-Factor Classification System

Dr. Nishant

Abstract: Background: Cervical spine pathology includes a broad spectrum of degenerative, ossified, deformity-related, traumatic, congenital, and postoperative conditions. Existing classification systems have improved communication and research within selected domains, including subaxial trauma, cervical deformity, degenerative cervical myelopathy (DCM), and ossification of the posterior longitudinal ligament (OPLL). However, no single clinically usable classification currently integrates the major variables that influence cervical decision-making: etiology, number of involved levels, compression phenotype, sagittal alignment, instability, neurological severity, approach-specific modifiers, and patient-related risk. Objective: To propose a modular cervical spine classification, the CERVICAL Classification, designed to standardize description, improve interdisciplinary communication, support surgical planning, and create a framework for future outcome validation across adult cervical compressive, deformity, OPLL, instability, and degenerative pathologies. Methods: A narrative synthesis of contemporary cervical spine classification systems and recent literature was performed. Key deficiencies in existing systems were identified, including disease-specific fragmentation, incomplete integration of dynamic instability, limited incorporation of compression direction and deformity, and inadequate representation of host-related modifiers. A modular classification was then developed using clinically measurable domains relevant to diagnosis, treatment selection, prognosis, and research standardization. Results: The proposed CERVICAL Classification includes eight domains: Cause, Extent, Radiological compression phenotype, Vertebral alignment, Instability, Cord/neural status, Approach modifiers, and Life/host factors. Each domain is coded independently, allowing concise case representation while preserving clinical nuance. OPLL-specific modifiers include K-line status, canal-occupying ratio, suspected dural ossification, and OPLL morphology. Neurological grading incorporates mJOA-based categories for mild, moderate, and severe myelopathy. Conclusion: The CERVICAL Classification is proposed as a comprehensive, modular, surgically actionable framework for adult cervical spine disease. It is not intended to replace validated trauma or deformity systems; rather, it integrates currently fragmented domains into a unified language. Prospective validation is required to determine interobserver reliability, predictive validity, and correlation with outcomes including mJOA recovery, Neck Disability Index, pain scores, complications, revision surgery, and patient-reported quality of life.

Keywords: Adult cervical disorders, cervical spine, classification system, etiology, imaging, biomechanics, neurology, surgical approach, host factors, spine surgery

How to Cite?: Dr. Nishant, "Adult Cervical Spine Disorders: A Comprehensive Etiological, Imaging-Based, Biomechanical, Neurological, Surgical, and Host-Factor Classification System", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 1474-1479, https://www.ijsr.net/getabstract.php?paperid=SR26627074007, DOI: https://dx.doi.org/10.21275/SR26627074007

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