Imaging Evaluation of Bone Tumors in the Cervical Spine: A Comprehensive Review

The cervical spine, a critical junction between the head and torso, is a rare but significant site for both primary and metastatic tumors. While primary tumors of the cervical spine are uncommon, certain types, such as chordomas and giant cell tumors, are particularly notable for their potential to affect this region. Metastatic lesions, although more frequent, present unique diagnostic and therapeutic challenges due to the complex anatomy of the cervical spine. Imaging is indispensable for the evaluation of cervical spine tumors, serving as the foundation for diagnosis, treatment planning, and monitoring therapeutic outcomes. Radiography, CT and MRI are the primary modalities used to assess tumor morphology, extent and relationship to surrounding structures. However, imaging alone may not always yield a definitive diagnosis, as some tumors lack distinctive features. Nevertheless, a combination of clinical presentation, epidemiological factors, and imaging findings often enables radiologists and clinicians to narrow the differential diagnosis and guide further management. Precise imaging interpretation is essential to prevent devastating clinical consequences resulting from diagnostic error, such as irreversible neurological damage, avoidable death, and significant long-term disability. This review provides a comprehensive overview of tumors that can involve the cervical spine, emphasizing their clinical and imaging characteristics. By highlighting key diagnostic features and discussing the latest advancements in imaging technology, aims to enable physicians in radiology, pathology, and clinical departments to gain a more comprehensive understanding of the imaging, pathological, and clinical characteristics of cervical spine tumors, thereby reducing misdiagnosis rates and alleviating the burden on patients.