Institute of Anatomy, Faculty of Medicine, Comenius University, Sasinkova 2, 81372 Bratislava, Slovak Republic.
Department of Neurosurgery, Faculty of Medicine, University Hospital, Comenius University, Limbová 5, 833 05 Bratislava, Slovak Republic.
J Clin Neurosci. 2020 Mar;73:259-263. doi: 10.1016/j.jocn.2020.01.074. Epub 2020 Jan 29.
The anomalous anatomical arrangement of the cervical spinal nerve roots within the spinal canal can complicate the surgical treatment of several pathologies. This work aimed to reveal intraspinal anatomical anomalies of the extradural and also intradural cervical spinal nerve roots courses. The anatomical study was realised in 43 cadavers with a mean age of 53.7 (32 men and 11 women). After opening the spinal canal and also the dural sac the intradural and extradural anomalies of the cervical spinal nerve roots (bilaterally) were explored and documented. We found completely 49 cases (56.98%) of intraspinal cervical nerve root anomalies. Extradural anomalies were found in 11 cases (12.79%) including atypical spacing, two roots exiting through one neuroforamen, extradural communications, aberrant root. Intradural anomalies observed in 28 cases (32.56%) comprised: communications between the dorsal roots and ventral roots separately or together and the multiple communications. Other anomalies (10 cases, 11.63%) included various types of atypical spacing of the roots and their asymmetry. All the results are differentiated according to the plexus type (pre-, postfixed, normotyped). This study describes intraspinal (extradural and intradural) anatomical anomalies of the cervical spinal nerve root courses. Knowledge of these variabilities should help to prevent the failure of several medical procedures.
颈椎脊髓神经根在椎管内的异常解剖排列可能使几种病理的手术治疗复杂化。本工作旨在揭示硬膜外和硬脊膜内颈椎脊神经根的椎管内解剖异常。解剖研究在 43 具尸体中进行,平均年龄为 53.7 岁(32 名男性和 11 名女性)。在打开椎管和硬脊膜囊后,探查并记录了颈椎脊神经根(双侧)的硬脊膜内和硬脊膜外异常。我们发现完全 49 例(56.98%)颈椎脊神经根脊髓内异常。硬膜外异常 11 例(12.79%),包括非典型间隔、两根经一个神经孔穿出、硬膜外交通、异常根。硬脊膜内异常 28 例(32.56%)包括:背根和腹根单独或一起沟通,以及多个沟通。其他异常(10 例,11.63%)包括各种类型的神经根非典型间隔和不对称。所有结果均根据丛类型(前置、后置、正常型)进行区分。本研究描述了颈椎脊髓神经根行程的硬脊膜内(硬膜外和硬脊膜内)解剖异常。了解这些变异性有助于预防多种医疗程序的失败。