X-ray of spondylosis of the cervical spine

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Author: Mikael Häggström [notes 1]


For suspected osteoarthritis of the cervical spine, recommended projections are:

  • Posteroanterior
  • Lateral
  • 45° left and right oblique


Grade III spondylosis with moderate disk space narrowing.

On projectional radiography ("X-ray") of the cervical spine, the following radiographic system is recommended in terms of interobserver reliability:[1]

Kellgren grading of cervical disc degeneration[2]
  • Minimal anterior osteophytosis
  • Definite anterior osteophytosis
  • Possible disc space narrowing
  • Some endplate sclerosis
  • Moderate disc space narrowing
  • Definite endplate sclerosis
  • Osteophytosis
  • Severe disc space narrowing
  • Endplate sclerosis
  • Multiple large osteophytes.


It is acceptable to simplify the severity of spondylosisto mild (Kellgren grades I to II), moderate (Kellgren grade III) and severe (Kellgren grade IV).

See also: General notes on reporting


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.


  1. Kettler, Annette; Wilke, Hans-Joachim (2005). "Review of existing grading systems for cervical or lumbar disc and facet joint degeneration ". European Spine Journal 15 (6): 705–718. doi:10.1007/s00586-005-0954-y. ISSN 0940-6719. 
  2. Ofiram, Elisha; Garvey, Timothy A.; Schwender, James D.; Denis, Francis; Perra, Joseph H.; Transfeldt, Ensor E.; Winter, Robert B.; Wroblewski, Jill M. (2009). "Cervical degenerative index: a new quantitative radiographic scoring system for cervical spondylosis with interobserver and intraobserver reliability testing ". Journal of Orthopaedics and Traumatology 10 (1): 21–26. doi:10.1007/s10195-008-0041-3. ISSN 1590-9921.