Nonthasaen Pawaree, Nasu Hisayo, Kagawa Eiichiro, Akita Keiichi
Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
JA Kyosai Research Institute, JA Kyosai Building 5th Floor, 2-7-9 Hirakawacho, Chiyoda-ku, Tokyo, 102-0093, Japan.
Surg Radiol Anat. 2018 May;40(5):571-580. doi: 10.1007/s00276-017-1963-3. Epub 2017 Dec 27.
The current study was conducted to clarify the morphology of the extraforaminal ligament (EFL) at the cervicothoracic junction and to compare the attachment of the EFL and the positional relation between the EFL and the spinal nerves, additionally to clarify the details within the connecting bundles at the cervicothoracic junction.
The EFLs from the 4th cervical to the 4th thoracic vertebrae were dissected in 56 sides of 28 Japanese cadavers (11 males, 17 females). The range of age was 62.0-99.0 years. In addition, connecting bundles were analyzed by histological examination.
Ventral to the spinal nerve, the capsulotransverse ligament (CTL), transforaminal ligament (TFL) and the ligament between the 7th cervical vertebra and the 1st rib were attached to the transverse process and rib. The EFL ventral to the 1st thoracic nerve was not observed in all sides. Dorsal to the spinal nerve, the anterior part of the superior costotransverse ligament (ASCL) and the ligament homologous to the ASCL were attached to the transverse process and rib. The superior radiating ligament (SRL) and the ligament homologous to the SRL were identified. The connecting bundles identified between the 7th cervical and the 1st thoracic nerve were histologically confirmed to consist of nerves and vessels.
The EFLs at the cervicothoracic junction were found to be homologous. The connecting bundles were observed between the 7th cervical and the 1st thoracic nerve. Interestingly, the 1st thoracic level alone might be a unique level at the cervicothoracic junction.
进行本研究以阐明颈胸交界处椎间孔外韧带（EFL）的形态，比较EFL的附着情况以及EFL与脊神经之间的位置关系，并进一步阐明颈胸交界处连接束的详细情况。
在28具日本尸体（11例男性，17例女性）的56侧解剖了第4颈椎至第4胸椎的EFL。年龄范围为62.0 - 99.0岁。此外，通过组织学检查分析连接束。
在脊神经腹侧，关节横韧带（CTL）、椎间韧带（TFL）以及第7颈椎与第1肋之间的韧带附着于横突和肋骨。在所有侧均未观察到第1胸神经腹侧的EFL。在脊神经背侧，肋横突上韧带（ASCL）的前部以及与ASCL同源的韧带附着于横突和肋骨。识别出了上放射状韧带（SRL）以及与SRL同源的韧带。在第7颈椎和第1胸神经之间识别出的连接束经组织学证实由神经和血管组成。
发现颈胸交界处的EFL具有同源性。在第7颈椎和第1胸神经之间观察到连接束。有趣的是，仅第1胸段水平可能是颈胸交界处的一个独特水平。
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