Mercer Susan R, Bogduk Nikolai
Department of Anatomy and Structural Biology, University of Otago, Dunedin, New Zealand.
Clin Anat. 2003 Nov;16(6):484-93. doi: 10.1002/ca.10121.
In view of the disparities in the anatomical, clinical, and biomechanical literature this study was undertaken to reappraise the gross anatomy of ligamentum nuchae with the objective of providing an accurate anatomical basis for biomechanical studies and for clinical theories and practices. Ligamentum nuchae was studied by gross dissection in ten embalmed human adult cadavers and was found to be comprised of two structures: a dorsal raphe and a midline fascial septum. The dorsal raphe was formed by the interweaving of the right and left upper trapezius, splenius capitis, and rhomboid minor. It spanned the cervical spine and was firmly attached to the external occipital protuberance and to the spinous process of C7. The fascial septum consisted of dense connective tissue and ran ventrally from the midline raphe to be confluent with the interspinous ligaments and atlanto-axial and atlanto-occipital membranes. These findings agree with those anatomical descriptions that portray ligamentum nuchae as a two-part structure but not with those studies in which it is characterized as a strong ligament attaching to all cervical spinous processes. Importantly, the findings of this study emphasize the need for clinical and biomechanical literature to portray the gross anatomy of ligamentum nuchae accurately.
鉴于解剖学、临床和生物力学文献中存在的差异，本研究旨在重新评估项韧带的大体解剖结构，以便为生物力学研究以及临床理论和实践提供准确的解剖学基础。通过对十具防腐处理的成年人体尸体进行大体解剖研究项韧带，发现它由两个结构组成：一条背侧缝和一个中线筋膜隔。背侧缝由左右上斜方肌、头夹肌和小菱形肌相互交织形成。它跨越颈椎，牢固地附着于枕外隆凸和第7颈椎棘突。筋膜隔由致密结缔组织构成，从中间缝向腹侧延伸，与棘间韧带以及寰枢和寰枕膜融合。这些发现与将项韧带描述为两部分结构的解剖学描述一致，但与那些将其描述为附着于所有颈椎棘突的强韧韧带的研究不同。重要的是，本研究结果强调临床和生物力学文献需要准确描述项韧带的大体解剖结构。
