Posterior Cervical Space Overview

Summary Thoughts: Posterior Cervical Space

The posterior cervical space ( PCS ) lies in the lateral neck deep to the sternocleidomastoid (SCM) and trapezius muscles and includes the triangle of fat between them. This triangle of fat is superficial to the paraspinal muscles and is known clinically as the posterior triangle of the neck. The PCS is small superiorly, encompassing just a region of tissue around the mastoid tip, but it expands inferiorly to encompass most of the lateral neck.

The most frequent pathology to affect the PCS is inflammatory or malignant lymphadenopathy in the spinal accessory chain. Identifying the likely source of the primary tumor is of great importance. Other pathology in the PCS is often related to CNXI, which runs obliquely across the PCS, or the brachial plexus, which traverses the lower PCS.

Imaging Approaches and Indications

Masses and inflammation of the PCS may be imaged either with CECT or MR of the neck, depending on regional preferences. Be sure to evaluate the entire PCS, from the mastoid tip to the clavicles.