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The sinuvertebral nerves at the craniovertebral junction: a microdissection study.

C Rennie1, M R Haffajee, M A A Ebrahim

  • 1Department of Clinical Anatomy, University of Kwa Zulu Natal, Durban, South Africa. rennie@ukzn.ac.za

Clinical Anatomy (New York, N.Y.)
|July 19, 2012
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Summary

The upper three cervical sinuvertebral nerves (SVNs) innervate craniovertebral junction structures. This study details their origins and courses, crucial for understanding whiplash pain mechanisms.

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Area of Science:

  • Anatomy
  • Neuroscience
  • Orthopedics

Background:

  • The cervico-occipital region is vulnerable to whiplash injuries.
  • Upper cervical sinuvertebral nerves (SVNs) are implicated in pain signaling from craniovertebral junction (CVJ) structures.

Purpose of the Study:

  • To meticulously detail the origin, course, and intraspinal distribution of the SVNs at C0-C1, C1-C2, and C2-C3 levels.
  • To enhance understanding of pain pathways in the upper cervical spine.

Main Methods:

  • Microdissection of 50 embalmed adult, fetal, and neonatal cervical spines.
  • Performed laminectomy with occipital craniectomy or intervertebral level sectioning to expose the CVJ.
  • Detailed observation under magnification (8-40×).

Main Results:

  • All three cervical SVNs arise from somatic and sympathetic roots.
  • C1 and C2 SVNs exhibit variable numbers.
  • C2 and C3 SVNs innervate most CVJ structures and the basiocciput; C1 SVN supplies a small part of the atlanto-occipital joint.
  • Intraspinal SVN branches follow CVJ arteries, supplying dura mater, ligaments, and soft tissues.

Conclusions:

  • The detailed anatomy of cervical SVNs is described.
  • Findings contribute to understanding the neuroanatomy of whiplash-associated pain.
  • Provides a basis for further research into CVJ pain mechanisms.