Surgical anatomy of the anterior cervical spine: the disc space, vertebral artery, and associated bony structures.

نویسنده

  • P Petty
چکیده

OBJECTIVE To elucidate the relationships between the neurovascular structures and surrounding bone, which are hidden from the surgeon by soft tissue, and to aid in avoiding nerve root and vertebral artery injury in anterior cervical spine surgery. METHODS Using six cadaveric spines, we measured important landmarks on the anterior surface of the spine, the bony housing protecting the neurovascular structures in the lateral disc space, and the changes that occur during the discectomy with interbody distraction of the vertebral bodies. The measurements included the distance between the medial borders of the longus colli muscle at the level of each interspace; the width and height of each disc space at the midline; the width and height of the costal process; the distances between the cranial tip of the uncinate process (UP) and the vertebral body (VB) above and from the tip of the UP to the vertebral artery; the anteroposterior diameter or the extent of the disc spaces in the midline; the height at the midpoint of the distracted disc space; the UP-VB distance in distraction; and the width of the visible nerve root. RESULTS The distance between the medial borders of the longus colli muscles increased in a rostral to caudal direction. The height of the UP was shortest at C4-C5 and greatest at C5-C6; the width was narrowest at C4-C5 and widest at C6-C7. The width of the costal process measured from the VB to the anterior tubercle was narrowest at C2-C3 and widest at C6-C7. The midpoint height of the costal process was smallest at C6-C7 and tallest at C4-C5 and C5-C6. The nondistracted UP-vertebral artery distance was the shortest at C2-C3 and longest at C4-C5. The nondistracted UP-VB distance averaged 1 mm at C2-C3 and C6-C7 and 1.5 mm at C4-C5. The height of the distracted disc space was shortest at C2-C3 and C6-C7. The UP-VB distance after distraction was greatest at C4-C5. Only at the C2-C3 interspace was the nerve always above the process. The vertebral artery entered the foramen transversarium of C6 in all the specimens. CONCLUSION Although avoiding unfortunate injury is not always possible, understanding the locations and relations among the anatomic features is the only safeguard against unwarranted damage.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The Cervical Sequestrated Disc Fragment Presenting as Mass Lesion: Case Report and Review of the Literature

Background & Importance: Disc herniation is defined as the prolapsed of material disc into the spinal canal. If the disc fragment is free in spinal canal, it is called sequestration disc fragment. Occasionally, alteration in sequestration disc fragment makes the diagnosis of the disc herniation, challenging. Case Presentation: We reviewed a rare case of the cervical sequestrated disc...

متن کامل

Anterior Cervical Incision and Thoracotomy for Cervico-thoracic, Thoracic, and Thoracolumbar Spine Surgery: A Clinical Series

Introduction:Surgical treatment of diseases in cervicothoracic, thoracic and thoracolumbar regions can be a challenging issue. Cooperation of the thoracic surgeons and spine surgeons can improve the outcomes and decrease the complications of patients who underwent these approaches.Materials & Methods: The participants of this study consisted of seventeenpatients suffering from different types o...

متن کامل

Oblique Corpectomy to Manage Cervical Myeloradiculopathy

Background. The authors describe a lateral approach to the cervical spine for the management of spondylotic myeloradiculopathy. The rationale for this approach and surgical technique are discussed, as well as the advantages, disadvantages, complications, and pitfalls based on the author's experience over the last two decades. Methods. Spondylotic myelo-radiculopathy may be treated via a lateral...

متن کامل

CerviCal anterior ForaMinotoMy

Cervical anterior foraminotomy (AF) is an anterior surgical technique for the cervical spine aimed to decompress intervertebral foramen and lateral side of the spinal canal. This technique aims to remove the offending lesion, either a disc fragment or osteophyte compressing the neural structures, via a bony window at the uncovertebral area; while preserving the structure and functions of the in...

متن کامل

EVALUATION OF THE RESULTS OF SURGICAL AND MEDICAL TREATMENT IN 16 PATIENTS WITH VERTIGO SECONDARY TO CERVICAL SPONDYLOSIS

 ABSTRACT Background: In patients with cervical spondylosis, cord compression and impingement of cord vessels as well as the vertebral artery may be accompanied by vertigo. We evaluated improvement of vertigo in these patients after surgical and medical treatment. Methods: In this prospective study we reviewed 16 patients with vertigo suspected of cervical spondylosis, admitted to our hospital ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Neurosurgery

دوره 41 1  شماره 

صفحات  -

تاریخ انتشار 1996