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The supraodontoid space or "apical cave" at the craniocervical junction: a microdissection study
M R Haffajee1, C Thompson, S Govender
1Department of Clinical Anatomy, University of KwaZulu Natal, Durban, South Africa. haffajeem@ukzn.ac.za
Clinical Anatomy (New York, N.Y.)
|June 4, 2008
Summary
This study details the extradural supraodontoid space anatomy at the craniocervical junction. Microdissection revealed its boundaries and contents, aiding surgical approaches to this critical area.
Area of Science:
- Anatomy
- Neurosurgery
- Craniocervical Junction
Background:
- The extradural supraodontoid space at the craniocervical junction (CCJ) is prone to neurological compression from various lesions.
- Transoral surgery is a common approach for decompression in this region.
- Detailed microanatomy of this space is not well-documented.
Purpose of the Study:
- To delineate the boundaries and contents of the extradural supraodontoid space.
- To provide detailed microanatomical knowledge for surgical planning.
Main Methods:
- Microdissection of 23 adult cadaveric CCJ specimens.
- Utilized a Zeiss DXE Microscope for detailed visualization.
- Focused on the space between the tectorial and atlanto-occipital membranes.
Main Results:
- Identified the supraodontoid space as a posterior-facing cave with specific boundaries (alar ligament floor, anterior atlanto-occipital membrane roof).
- Contents include the apical ligament, fatty layer, cruciate ligament, venous plexuses, arterial arcade, fat pads, and sinuvertebral nerves.
- No synovial membrane was observed in the space.
Conclusions:
- Detailed anatomical knowledge of the supraodontoid space is crucial for safe and effective transoral surgery.
- The findings enhance understanding of the anterior CCJ region for neurosurgeons and anatomists.
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