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Anatomic considerations of the vertebral artery: implications for anterior decompression of the cervical spine
J Lu1, N A Ebraheim, G M Georgiadis
1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.
Insights
This study measured the vertebral artery
Area of Science:
- Anatomy
- Surgical anatomy
- Cervical spine anatomy
Background:
- The precise anatomical relationship between the vertebral artery and surrounding structures in the cervical spine is crucial for surgical procedures.
- Understanding these spatial relationships aids in preventing iatrogenic injury during lateral cervical canal decompression.
Purpose of the Study:
- To quantitatively assess the anatomical position of the vertebral artery relative to the longus colli muscle and vertebral body.
- To provide detailed measurements from C6 to C3 to inform surgical approaches in the lateral cervical canal.
Main Methods:
- Anatomic dissection and precise measurements of the vertebral artery.
- Measurements were taken relative to the medial margin of the longus colli muscle and the anterior margin of the vertebral body.
- Data collected from C6 to C3 vertebral levels.
Main Results:
- The vertebral artery's angle relative to the midline averaged 4.3 degrees.
- The distance between the longus colli and vertebral artery decreased from C6 (11.5 mm) to C3 (9.0 mm).
- The distance between the vertebral body and vertebral artery increased from C6 (7.2 mm) to C3 (9.6 mm).
Conclusions:
- The vertebral artery shifts medially and posteriorly from C6 to C3 relative to surrounding structures.
- This detailed anatomical understanding enhances surgical safety and efficacy in lateral cervical decompression procedures.
Abstract:
Anatomic dissection and measurements of the vertebral artery relative to the medial margin of the longus colli and the anterior margin of the vertebral body from C6 to C3 were performed in this study. The average angle of the vertebral artery relative to the midline was 4.3 +/- 2.6 degrees overall. The average distance between the medial margin of the longus colli and medial margin of the vertebral artery gradually decreased from the C6 level (11.5 +/- 1.0 mm) to the C3 level (9.0 +/- 1.3 mm). The average distance between anterior margin of the vertebral body and anterior margin of the vertebral artery gradually increased from the C6 level (7.2 +/- 1.9 mm) to the C3 level (9.6 +/- 2.1 mm). The distance between medial borders of the longus colli muscles gradually decreased from the C6 level (13.8 +/- 2.2 mm) to the C3 level (7.9 +/- 2.2 mm). Relative to the medial margin of the longus colli muscle and the anterior margin of the vertebral body, the vertebral artery is more lateral and anterior at the C6 level but more medial and posterior at C3 level. This knowledge may facilitate effective decompression of the lateral cervical canal and improve the margin of safety of the surgeon.