Cervical Enlargement

intumescentia cervicalis

The cervical enlargement is a widening of the spinal cord in the lower neck where extra grey matter is needed to control the arms. It gives rise to the nerve roots that form the brachial plexus. The cord is thickest here.

Anatomical Data

Structure & Connections

Location	Spinal cord segments C4 to T1, lying roughly within the C3 to T1 vertebral levels
Parts	Enlarged ventral horns (motor neurons for the upper limb) Enlarged dorsal horns Roots of C5-T1 spinal nerves
Connections	Brachial plexus Lateral corticospinal tract Fasciculus cuneatus Rubrospinal tract
Blood Supply	Anterior spinal artery; Posterior spinal arteries; Segmental medullary branches of the vertebral, ascending cervical and deep cervical arteries

Biomechanics

Function & Actions

Houses the neurons that control and receive sensation from the shoulders, arms and hands.

Clinical Relevance

Clinical Notes

Damage at the cervical enlargement produces mixed signs: lower motor neuron weakness and wasting in the arms with upper motor neuron signs in the legs. Central cord syndrome after hyperextension injury in an older person with cervical spondylosis typically affects the arms more than the legs. Cervical spondylotic myelopathy commonly compresses this region.

Pathology

Common Injuries & Conditions

Central Cord Syndrome

Damage to the central cervical cord, often from hyperextension, causing greater weakness of the arms than the legs.

Cervical Spondylotic Myelopathy

Gradual compression of the cervical cord by degenerative discs and bony spurs, causing clumsy hands, numbness and unsteady gait.

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