Kiray A, Arman C, Naderi S, Güvencer M, Korman E
Department of Anatomy, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
Clin Anat. 2005 Apr;18(3):179-85. doi: 10.1002/ca.20055.
Lack of knowledge of the anatomy of the cervical sympathetic trunk (CST) may complicate surgical procedures on the cervical spine. This study aims to define linear and angular relations of the CST with respect to consistent structures around it, including the number and size of the cervical ganglia, the distances between the CST and the longus colli muscle and the anterior tubercles of the transverse processes of cervical vertebrae. Morphometric parameters of the 24 CSTs of 12 adults were measured on both sides. The CST had superior, middle, and inferior (or cervicothoracic) ganglia in 20.8% of specimens; superior and inferior (or cervicothoracic) ganglia in 45.8%; superior, middle, vertebral, inferior, or cervicothoracic ganglia in 12.5%, and superior, vertebral, inferior or cervicothoracic ganglia in 20.8% of specimens. The superior ganglion was observed in all specimens, the middle ganglion and vertebral ganglion were each observed in 33.3%. There was no difference between the number of superior and vertebral ganglia between the right and left sides. The average distance between the CST and the medial border of the ipsilateral longus colli muscle (LCM) was 17.2 mm at C3 and 12.4 mm at C7. As the CSTs converged caudally, the LCMs diverged. The average distance between the anterior tubercles of transverse processes of the cervical vertebrae and the lateral borders of the ipsilateral CST was 3.4 mm at C4, 3.2 mm at C5, and 3.9 mm at C6. The presence of a vertebral ganglion and variations, such as the localization of the CST within the carotid sheath, are important. The anatomical landmarks described should assist the spinal surgeon to avoid injury of the CST.
对颈交感干（CST）解剖结构缺乏了解可能会使颈椎手术复杂化。本研究旨在确定CST相对于其周围恒定结构的线性和角度关系，包括颈神经节的数量和大小、CST与颈长肌以及颈椎横突前结节之间的距离。对12例成年人的24条CST双侧进行形态学参数测量。在20.8%的标本中，CST有上、中、下（或颈胸）神经节；45.8%有上、下（或颈胸）神经节；12.5%有上、中、椎、下或颈胸神经节；20.8%有上、椎、下或颈胸神经节。所有标本均观察到上神经节，中神经节和椎神经节各观察到33.3%。左右两侧上神经节和椎神经节的数量无差异。CST与同侧颈长肌（LCM）内侧缘的平均距离在C3处为17.2mm，在C7处为12.4mm。随着CST向尾侧汇聚，LCM向外侧分开。颈椎横突前结节与同侧CST外侧缘的平均距离在C4处为3.4mm，在C5处为3.2mm，在C6处为3.9mm。椎神经节的存在以及诸如CST在颈动脉鞘内的定位等变异很重要。所描述的解剖标志应有助于脊柱外科医生避免损伤CST。
