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. 2020 Aug;14(4):455-461.
doi: 10.14444/7060. Epub 2020 Jul 31.

Morphometric Study of the Cervical Spinal Canal Content and the Vertebral Artery

Evren AydoĞmuŞ  1 , Safiye Çavdar  2
Affiliations

Morphometric Study of the Cervical Spinal Canal Content and the Vertebral Artery

Evren AydoĞmuŞ et al. Int J Spine Surg. 2020 Aug.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: dorsal cervical nerve roots; spinal cord; vertebral artery.

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Conflict of interest statement

Disclosures and COI: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. None of the authors has any conflict of interest to disclose. All cadavers used in this study was donated for medical student's dissections and research purposes. All procedures performed in studies were approved by the Institutional Ethics Committee of Koç University.

Figures

Figure 1
Figure 1
The skin, subcutaneous tissue, muscles of the region, and the spinous processes and laminae of C1 to C7 vertebrae were removed. (a) The dura mater and the cervical spinal nerves within the dura were exposed. (b) The dura mater was longitudinally incised and the arachnoid matter was exposed. (c) The arachnoid matter was reflected and the dorsal rootlets were exposed. (d) Anterior to the spinal nerves the V2 segment of the vertebral artery was exposed.
Figure 2
Figure 2
(a,b) Measurements made on the cervical spinal nerve and the vertebral artery. A indicates angles between the spinal nerve and the spinal cord; B, distance between respective spinal nerves; C, width of spinal nerves; D, distance between of the spinal cord and the vertebral artery; E, the length of dorsal root entry zone.
Figure 3
Figure 3
(a) The spinal cord and the cervical spinal nerves have been exposed within the vertebral canal. (b) The relation of the spinal nerve and the vertebral artery (VA) has been exposed.
See this image and copyright information in PMC

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