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Cervical spine behavior for generalized loading is often characterized using a full three-dimensional flexibility matrix. While experimental studies have been aimed at determining cervical motion segment behavior, their accuracy and utility have been limited both experimentally and analytically. For example, the nondiagonal terms, describing coupled motions, of the matrices have often been omitted. Flexibility terms have been primarily represented as constants despite the known nonlinear stiffening response of the spine. Moreover, there is presently no study validating the flexibility approach for predicting vertebral motions; nor have the effects of approximations and simplifications to the matrix representations been quantified. Yet, the flexibility matrix currently forms the basis for all multibody dynamics models of cervical spine motion.