Summary
Twenty adult cadaveric cervical spines were sectioned longitudinally through the midline to display longitudinal sections of the vertebral bodies and disc spaces from C3 to T1. Computer-assisted anatomic images were obtained for measurements of the disc spaces and vertebral bodies. Anteroposterior (AP) depth gradually increased from 16.56±2.21 mm at C3 to 19.32±2.30 mm at C7. Greater values of AP depth at the inferior endplate were found at C5 (20.75±2.87 mm) and C6 (20.56±2.31 mm) compared with the values at C3 (18.26±1.82 mm), C4 (19.27±2.88 mm) and C7 (19.21±3.22 mm). The AP depth at the superior endplate was greater than that at the inferior endplate. The height of the disc space was found to be lowest at the posterior disc space from C2–3 to C7-T1 (2.95±0.86 mm at C2–3, 2.78±0.93 mm at C3–4, 2.45±0.79 mm at C4–5, 2.92±0.64 mm at C5–6, 2.46±0.59 mm at C6–7, 2.93±1.05 mm at C7-T1), when compared to the height of the disc space at the anterior disc space from C2–3 to C7-T1 (4.07±0.85 mm at C2–3, 4.34±1.18 mm at C3–4, 3.95±1.37 mm at C4–5, 3.55±1.37 mm at C5–6, 3.55±0.76 mm at C6–7, 3.67±1.17 mm at C7-T1). The mid-axis of the disc space was situated at approximately 3 mm above the anterior midpoint of the annulus fibrosus at the level of the lower cervical spine. To reach the posterior portion of the disc space from the anterior midpoint of the annulus fibrosus, a 5° cephalad angulation of the drill relative to the midaxis of the disc space is necessary. All these original data from cadavers may be helpful during anterior approach for discectomy, vertebrectomy and anterior screw-plate placement.
Résumé
20 colonnes cervicales issues de cadavres d'adultes ont été sectionnées longitudinalement sur la ligne médiane pour fournir des coupes longitudinales des corps vertébraux et des disques intervertébraux de C3 à T1. Les images anatomiques obtenues ont été traitées à l'aide d'un ordinateur pour fournir des mesures des disques intervertébraux et des corps vertébraux. L'épaisseur antéropostérieure (AP) augmentait progressivement de 16,56±2,21 mm en C3 à 19,32±2,30 mm en C7. Les valeurs les plus importantes de l'épaisseur AP au plateau vertébral inférieur ont été relevées en C5 (20,75±2,87 mm) et C6 (20,56±2,31 mm) alors qu'elles étaient plus faibles en C3 (18,26±1,82 mm), C4 (19,27±2,88 mm), et C7 (19,21±3,22 mm). L'épaisseur AP mesurée au plateau vertébral supérieur était plus importante que celle mesurée au plateau inférieur. La hauteur du disque intervertébral était moins élevée à la partie postérieure des disques intervertébraux de C2–C3 à C7-T1 (2,95±0,86 mm en C2–C3, 2,78±0,93 mm en C3–C4, 2,45±0,79 mm en C4–C5, 2,92±0,64 mm en C5–C6, 2,46±0,59 mm en C6–C7, et 2,93±1,05 mm en C7-T1) en comparaison avec celles relevées à la partie antérieure de l'espace de C2–C3 à C7-T1 (4,07±0,85 mm en C2–C3, 4,34±1,18 mm en C3–C4, 3,95±1,37 mm en C4–C5, 3,55±1,37 mm en C5–C6, 3,55±0,76 mm en C6–C7, et 3,67±1,19 mm en C7-T1). L'axe moyen du disque intervertébral était situé environ 3 mm audessus du point moyen antérieur de l'annulus fibrosus au niveau de la partie inférieure de la colonne cervicale. Pour atteindre la partie postérieure de l'espace intervertébral, à partir du point moyen antérieur de l'annulus fibrosus, il faut donner à la mèche une angulation de 5° vers la tête par rapport à l'axe moyen du disque intervertébral. Toutes ces données cadavériques originales peuvent rendre service au cours des abords antérieurs pour discectomie, vertébrectomie, et mise en place de plaque et de vis.
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Lu, J., Ebraheim, N.A., Yang, H. et al. Anatomic bases for anterior spinal surgery: surgical anatomy of the cervical vertebral body and disc space. Surg Radiol Anat 21 (Suppl 4), 235–239 (1999). https://doi.org/10.1007/BF01631392
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DOI: https://doi.org/10.1007/BF01631392