Shi Benchao, Zheng Xuefeng, Zhang Hui, Sun Chao, Cao Yanlin, Jin Anmin, Ding Zihai
*Department of Orthopedics, Zhujiang Hospital; and †Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, Guangdong, China.
Spine (Phila Pa 1976). 2015 Jan 1;40(1):E9-17. doi: 10.1097/BRS.0000000000000668.
A dissection-based study of 6 embalmed cadavers.
To identify and describe the extraforaminal ligaments (EFLs) in relation to the area of the cervical intervertebral foramina and to evaluate their clinical significance.
EFLs between the lumbar spinal nerves and the tissues surrounding the intervertebral foramens have been well established. However, research work has been undertaken to describe the local anatomy of the extraforaminal part of the cervical spine; detailed anatomic studies of the EFLs of cervical nerves have not been performed.
One hundred ninety-six cervical intervertebral foramina from 6 adult embalmed cadavers were studied, and the existence and type of the EFLs were identified. The morphology, quantity, origin, insertion, and the spatial orientation of the EFLs in the cervical region were observed, and the length, width, or diameter and thickness of the ligaments were measured with a vernier caliper.
The EFLs could be found from the second cervical to the first thoracic spinal nerve. These ligaments could be divided into 2 types: radiating ligaments, which connected the nerve root sleeves that radiated to the transverse processes, the wall of the intervertebral foramina, and even the adjacent nerve root through the small transverse foramen; transforaminal ligaments, which originated from the anteroinferior margin of cranial transverse process and inserts in the superior margin of the anterior tubercle of caudal transverse process crossing the spinal nerve ventrally.
Between the cervical spinal nerves and nearby structures, there are 2 types of the EFLs. The radiating ligaments may serve as a protective mechanism against traction and play an important role in the positioning of the nerves in the intervertebral foramen. However, in all probability, the transforaminal ligaments may be the underlying cause of the cervical radiculopathy.
基于6具防腐尸体的解剖学研究。
确定并描述与颈椎椎间孔区域相关的椎间孔外韧带（EFLs），并评估其临床意义。
腰椎脊神经与椎间孔周围组织之间的EFLs已得到充分证实。然而，关于颈椎椎间孔外部分的局部解剖学研究仍在进行中；尚未对颈神经的EFLs进行详细的解剖学研究。
对6具成年防腐尸体的196个颈椎椎间孔进行研究，确定EFLs的存在和类型。观察颈椎区域EFLs的形态、数量、起源、插入点和空间方向，并用游标卡尺测量韧带的长度、宽度、直径和厚度。
从第二颈椎到第一胸神经均可发现EFLs。这些韧带可分为两种类型：放射状韧带，连接放射至横突、椎间孔壁甚至通过小横孔连接相邻神经根的神经根袖；椎间孔韧带，起源于颅侧横突的前下缘，插入尾侧横突前结节的上缘，腹侧穿过脊神经。
在颈脊神经和附近结构之间，存在两种类型的EFLs。放射状韧带可能作为一种防止牵引的保护机制，并在椎间孔内神经的定位中起重要作用。然而，椎间孔韧带很可能是颈椎病的潜在病因。
