Arslan Mehmet, Açar Halil İbrahim, Cömert Ayhan
Department of Neurosurgery, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey.
Department of Anatomy, Ankara University School of Medicine, Sihhiye, 06100, Ankara, Turkey.
Surg Radiol Anat. 2017 Dec;39(12):1377-1383. doi: 10.1007/s00276-017-1896-x. Epub 2017 Jul 19.
The purpose of this study was to elucidate the anatomy and clinical importance of extraforaminal ligaments in the cervical region.
This study was performed on eight embalmed cadavers. The existence and types of extraforaminal ligaments were identified. The morphology, quantity, origin, insertion, and orientation of the extraforaminal ligaments in the cervical region were observed.
Extraforaminal ligaments could be divided into two types: transforaminal ligaments and radiating ligaments. It was observed that during their course, transforaminal ligaments cross the intervertebral foramen ventrally. They usually originate from the anteroinferior margin of the anterior tubercle of the cranial transverse process and insert into the superior margin of the anterior tubercle of the caudal transverse process. The dorsal aspect of the transforaminal ligaments adhere loosely to the spinal nerve sheath. The length, width and thickness of these ligaments increased from the cranial to the caudal direction. A single intervertebral foramen contained at least one transforaminal ligament. A total of 98 ligaments in 96 intervertebral foramina were found. The spinal nerves were extraforaminally attached to neighboring anterior and posterior tubercle of the cervical transverse process by the radiating ligaments. The radiating ligaments consisted of the ventral superior, ventral, ventral inferior, dorsal superior and dorsal inferior radiating ligaments. Radiating ligaments originated from the adjacent transverse processes and inserted into the nerve root sheath. The spinal nerve was held like the hub of a wheel by a series of radiating ligaments. The dorsal ligaments were the thickest. From C2-3 to C6-7 at the cervical spine, radiating ligaments were observed. They developed particularly at the level of the C5-C6 intervertebral foramen.
This anatomic study may provide a better understanding of the relationship of the extraforaminal ligaments to the cervical nerve root.
本研究旨在阐明颈椎区域椎间孔外韧带的解剖结构及其临床意义。
对8具防腐尸体进行研究。确定椎间孔外韧带的存在及其类型。观察颈椎区域椎间孔外韧带的形态、数量、起点、止点及走行方向。
椎间孔外韧带可分为两类：经椎间孔韧带和放射状韧带。观察发现，经椎间孔韧带在走行过程中从腹侧穿过椎间孔。它们通常起自上位横突前结节的前下缘，止于下位横突前结节的上缘。经椎间孔韧带的背侧与脊神经鞘疏松相连。这些韧带的长度、宽度和厚度自上向下逐渐增加。单个椎间孔至少含有一条经椎间孔韧带。在96个椎间孔中共发现98条韧带。脊神经通过放射状韧带在椎间孔外附着于相邻颈椎横突的前后结节。放射状韧带包括腹侧上、腹侧、腹侧下、背侧上和背侧下放射状韧带。放射状韧带起自相邻的横突，止于神经根鞘。脊神经被一系列放射状韧带像轮毂一样固定。背侧韧带最厚。在颈椎C2-3至C6-7节段观察到放射状韧带，在C5-C6椎间孔水平发育尤为明显。
本解剖学研究有助于更好地理解椎间孔外韧带与颈神经根的关系。
