Differentiated thyroid cancers are rarely associated with distant metastases and have 10-year survival rates higher than 80%; however, the prognosis deteriorates significantly if metastasis occurs. Bone is the second most common site of metastasis after the lungs in cases of thyroid cancer. Here we describe a case in which a 57-year-old female patient had extremely severe pain on the posterior neck. After magnetic resonance imaging, 18F-FDG PET CT and ultrasonography guided biopsy, right papillary thyroid carcinoma with cervical spine metastasis was suspected; therefore, she underwent surgery for removal of thyroid carcinoma and seventh cervical spine metastasis. Pathologic diagnosis was confirmed as left thyroid follicular carcinoma with seventh cervical spine metastasis and synchronous right thyroid papillary carcinoma. The patient then underwent an additional spinal tumor removal operation, I¹³¹ treatment and external radiation therapy. Complete removal of the cervical spine tumor could not be achieved due to intra-operative bleeding and the need to prevent damage to the spinal cord. Following treatment, the patient reported great relief from severe neck pain. This is a rare presentation of follicular thyroid carcinoma with cervical spine metastasis in Korea.