From the Guidelines
For patients with C6-C7 spondylitis, the first-line treatment should be non-steroidal anti-inflammatory drugs (NSAIDs) as they are considered the central role in drug treatment, according to the 2016 ASAS-EULAR management recommendations 1.
Treatment Overview
C6-C7 spondylitis refers to inflammation of the vertebrae at the C6-C7 level of the cervical spine. The primary goal of treatment is to reduce inflammation, alleviate pain, and improve quality of life.
Medication
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-choice drug treatment for C6-C7 spondylitis, as recommended by the 2016 ASAS-EULAR management recommendations 1.
- The use of analgesics, glucocorticoids, and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) is not recommended for patients with predominant axial involvement, including C6-C7 spondylitis 1.
- Biological DMARDs (bDMARDs), including TNFi and IL-17 inhibitors, may be considered for patients with high disease activity despite the use of at least two NSAIDs, and who have an elevated C reactive protein and/or definite inflammation on MRI and/or radiographic evidence of sacroiliitis 1.
Non-Pharmacological Management
- Physical therapy focusing on gentle neck stretches and strengthening exercises should be initiated once acute pain subsides.
- Application of heat or cold packs for 15-20 minutes several times daily can provide symptomatic relief.
- Maintaining proper posture, using ergonomic pillows, and avoiding activities that strain the neck are essential.
Further Evaluation
If symptoms persist beyond 4-6 weeks or include neurological symptoms like arm weakness or numbness, further evaluation with imaging studies and possibly consultation with a spine specialist is warranted. Spondylitis at this level can cause significant discomfort because the C6-C7 segment bears substantial mechanical stress and houses nerve roots that supply the arms and hands.
From the Research
C6-C7 Spondylitis Overview
- C6-C7 spondylitis refers to inflammation of the spinal vertebrae at the C6-C7 level, which can be caused by various factors, including traumatic injury, ankylosing spondylitis, or cervical spondylotic myelopathy.
- The management of C6-C7 spondylitis depends on the underlying cause and severity of the condition, and may involve surgical or non-surgical approaches 2, 3, 4.
Surgical Management
- Surgical management of C6-C7 spondylitis may involve anterior, posterior, or combined anterior-posterior approaches, depending on the specific condition and patient factors 2, 3, 4.
- A study published in 2004 reported a case of traumatic C6-C7 spondyloptosis managed with a single-stage combined anterior-posterior and anterior operation, resulting in successful restoration of the cervical spine without neurological deficits 2.
- Another study published in 2025 reported on the management of cervical fractures in ankylosing spondylitis, and found that posterior fusion was the most commonly performed surgery, followed by combined anterior-posterior fusion and anterior fusion 4.
Non-Surgical Management
- Non-surgical management of C6-C7 spondylitis may involve the use of nonsteroidal anti-inflammatory drugs (NSAIDs), cyclo-oxygenase-2 (COX-2) inhibitors, or other pharmacological therapies 5, 6.
- A study published in 2005 reported on the efficacy of COX-2 inhibition by etoricoxib and naproxen on the axial manifestations of ankylosing spondylitis, and found that both treatments were effective in reducing spine pain intensity 6.
- Another study published in 2005 reported on the pharmacological treatment of ankylosing spondylitis, and found that NSAIDs and COX-2 inhibitors were effective in reducing pain and improving physical function, while anti-tumor necrosis factor (TNF)-alpha agents were effective in reducing axial and peripheral symptoms 5.
Complications and Outcomes
- C6-C7 spondylitis can be associated with significant complications, including neurological deficits, spinal instability, and mortality 3, 4.
- A study published in 2025 reported on the outcomes of cervical fractures in ankylosing spondylitis, and found that good neurological outcomes were observed in 63.4% of cases, while poor outcomes were noted in 33.7% 4.
- The overall mortality rate for cervical fractures in ankylosing spondylitis was reported to be 2.9% 4.