Identification of the Seventh Cervical Vertebra by Palpation With Neck Rotation and Side Bending in Patients With Neck Pain

The ability to identify the correct vertebral level through examination is an important skill for clinicians in many different specialities (1,2). Two methods for identifying seventh cervical vertebra are commonly used; the conventional palpation method, which identifies the most prominent cervical spinous process as the seventh cervical (C7) spinous process and flexion-extension method which identifies the lowest freely moving spinous process as C6 and the following stationary cervical spinous process as C7. One study found the accuracy of the conventional palpation method is 37.5% while the accuracy of the flexion-extension is 77.1%. Another method is done by detecting the most prominent three vertebrae at cervicothoracic junction then three palpating fingers will be placed paravertebrally to the left of the cervicothoracic region against the left side of the assumed C7 and Tl spinous processes. When rotation or lateral flexion is facilitated, C7 is expected to move significantly further than the more slowly reacting Tl spinous process.

Inclusion criteria

• neck pain, age (18- 60) male and female

Exclusion criteria

• with suspected ankylosing spondylitis, previous surgery on the cervical spine or congenital malformation of the cervical region.