Background: The use of smartphones has increased drastically over the last decade. Improper posture, and excessive use have raised concerns about their effect on cervical spine health. Methods: -MEDLINE database was searched for articles using the keywords: neck pain, musculoskeletal symptoms, cervical spine, cervical -biomechanics, mobile phone, cell phone, smart phone, smartphone, mobile device, touchscreen phone. Full-text Articles from 1990 to 2017 were included. Statistical comparisons and tables are provided when appropriate. Results: 43 articles were included for review. First article was published in 2002. Majority of studies were published between 2010 – 2017 (36 vs. 5 in 2000-2010). Studies included were of cross-sectional, experimental, or systemic review design. No longitudinal studies were identified. We categorized articles into 5 subgroups; we found 14 biomechanical studies, 10 electromyographic studies, 5 ergonomical studies, 14 clinical studies, and no surgical studies. Conclusions: Text-neck posture leads to significant changes in cervical spine biomechanics. Increased compressive load, antero-posterior shear load, and high cervical extensor muscles activity were associated with forward flexed neck posture adapted by smartphones users. Neurosurgeons need to take the abnormal posture and load distribution into consideration when planning for surgical interventions, especially in young adults with history of excessive use of smartphones.