AydoĞmuŞ Evren, Çavdar Safiye
Department of Neurosurgery, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Department of Anatomy, Koç University, School of Medicine Istanbul, Turkey.
Int J Spine Surg. 2020 Aug;14(4):455-461. doi: 10.14444/7060. Epub 2020 Jul 31.
The morphological features of the cervical spinal nerves (C1-C8), their dimensions, and their anatomical relations with the vertebral artery are important for safe spinal surgery. The aim of the present study is to give detailed morphological data of the region to avoid complications.
Five formalin-fixed adult cadavers were studied. The cervical spinal nerves and the vertebral artery were exposed via the posterior approach, and detailed anatomy and morphometric measurements were evaluated. The following measurements were documented: angles between the spinal nerve and the spinal cord of C1 to C8, width of the C1 to C8 spinal nerves at their origin, distance of the spinal cord to the vertebral artery, number of dorsal rootlets, length of the dorsal root entry zone of C1 to C8, and distance between respective spinal nerves. Further, the average length and width of the transverse foramen were measured.
The average angle between the spinal cord and the spinal nerve within the vertebral canal ranged between 54 and 87 degrees and were most acute at C5 (54 degrees) compared to the rest of the cervical spinal nerves. The average width of the spinal nerves (mean ± SD), was thickest at C5 (5.7 ± 1.2 mm) and C6 (5.8 ± 0.7 mm). The average largest distance between the vertebral artery and the spinal cord was at C2 (14.3 ± 1.7 mm) and the smallest at C5 (7.3 ± 0.9 mm) and C6 (7.3 ± 2.2 mm) spinal levels. The number of dorsal rootlets was most numerous at C6 (8.25 ± 0.6) and C7 (7.25 ± 0.9). The dorsal root entry zone length was the largest at C5 (13.0 ± 1.6 mm) and C6 (13.75 ± 0.5 mm). The distance between respective spinal nerves was largest between C2 and C3 (11.8 ± 2.2) and C7 and C8 (11.5 ± 0.6).
The knowledge of detailed anatomy of the cervical spine (C1-C8) and its relations with the vertebral artery will reduce the unwanted damage to the vital structures of the region.
颈脊神经(C1 - C8)的形态特征、尺寸及其与椎动脉的解剖关系对于安全的脊柱手术至关重要。本研究的目的是提供该区域的详细形态学数据以避免并发症。
对五具用福尔马林固定的成年尸体进行研究。通过后路暴露颈脊神经和椎动脉,并评估详细的解剖结构和形态测量数据。记录了以下测量结果:C1至C8脊神经与脊髓之间的角度、C1至C8脊神经起始处的宽度、脊髓到椎动脉的距离、背根丝的数量、C1至C8背根进入区的长度以及各脊神经之间的距离。此外,还测量了横突孔的平均长度和宽度。
椎管内脊髓与脊神经之间的平均角度在54度至87度之间,与其他颈脊神经相比,C5处的角度最锐(54度)。脊神经的平均宽度(平均值±标准差)在C5(5.7±1.2毫米)和C6(5.8±0.7毫米)处最厚。椎动脉与脊髓之间的平均最大距离在C2水平(14.3±1.7毫米),在C5(7.3±0.9毫米)和C6(7.3±2.2毫米)脊髓节段处最小。背根丝的数量在C6(8.25±0.6)和C7(7.25±0.9)处最多。背根进入区长度在C5(13.0±1.6毫米)和C6(13.75±0.5毫米)处最大。各脊神经之间的距离在C2和C3之间(11.8±2.2)以及C7和C8之间(11.5±0.6)最大。
了解颈椎(C1 - C8)的详细解剖结构及其与椎动脉的关系将减少对该区域重要结构的意外损伤。