A possible correlation between vertebral artery insufficiency and degenerative changes in the cervical spine

Stręk, Paweł; Reroń, E; Maga, Paweł; Modrzejewski, M; Szybist, N

doi:10.1007/s004050050094

Cited by 47 publications

(27 citation statements)

References 15 publications

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“…The laterally projecting uncovertebral osteophytes and overlying fibroligamentous thickening can also produce compression of the vertebral artery (Prescher, 1998;Strek et al, 1998). Uncovertebral osteophytes can create surgical difficulties due to obscured anatomical details when decompressing a stenotic intervertebral foramen (Hakuba, 1976;Ebraheim et al, 1996a,b;Jho, 1996).…”

Section: Discussionmentioning

confidence: 95%

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

Yılmazlar¹,

Kocaelı²,

Uz³

et al. 2003

Clinical Anatomy

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The vertebral artery, cervical spinal nerves, spinal nerve roots, and the bony and ligamentous tissue related to the cervical vertebrae are structures whose anatomy determines the path of a surgical approach. Defining the anatomy and, in particular, determining the precise location of vulnerable structures at the intervertebral foramen and the uncovertebral foraminal region (UVFR), a region defined by the uncinate process anteriorly, the facet joint posteriorly and the foramen transversarium laterally, has critical significance when selecting the safest surgical approach. We studied the anatomy of the vertebral artery, cervical spinal nerves, and spinal nerve roots within the UVFR in six cadaver specimens. We also obtained measurements of bony structures in 35 dry cervical vertebral columns, from C3-C7. The uncinate process (UP) projects superiorly from the posterolateral aspect of each cervical vertebral body, except for the first and second vertebrae. Because the posterior part of the UP lies adjacent to the vertebral artery, spinal nerve, and spinal nerve roots, its resection creates sufficient space to decompress these structures directly. The posterolateral surface of the UP is covered by ligamentous tissue that originates from the posterior longitudinal ligament and protects the neural and vascular structures during their decompression in the UVFR.

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Section: Discussionmentioning

confidence: 95%

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

Yılmazlar¹,

Kocaelı²,

Uz³

et al. 2003

Clinical Anatomy

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“…A pathophysiologic explanation is that age-related degenerative changes in the cervical spine can compress major feeding arteries like the vertebral artery [14], anterior spinal artery and its ventral branches, or the radicular arteries of the neuroforamina [7,15]. As a result, the blood flow velocity within vertebral arteries can be pathologically reduced [16] while perfusion to key parts of the spinal cord is compromised [16]. Moreover, spondylotic deformations of the cervical spine such as kyphosis have been identified to be involved in the onset or the progression of the disease by interfering with the spinal cord vascular network [17,18].…”

Section: Ischemiamentioning

confidence: 99%

Pathobiology of cervical spondylotic myelopathy

2014

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In this narrative review, we aim to outline what is currently known about the pathophysiology of cervical spondylotic myelopathy (CSM), the most common cause of spinal cord dysfunction. In particular, we note the unique factors that distinguish it from acute spinal cord injury. Despite its common occurrence, the reasons why some patients develop severe symptomatology while others have few or no symptoms despite radiographic evidence confirming similar degrees of compression is poorly understood. Neither is there a clear understanding of why certain patients have a stable clinical myelopathy and others present with only mild myelopathy. Moreover, the precise molecular mechanisms which contribute to the pathogenesis of the disease are incompletely understood. The current treatment method is decompression of the spinal cord but a lack of clinically relevant models of CSM have hindered the understanding of the full pathophysiology which would aid the development of new therapeutic avenues of investigation. Further elucidation of the role of ischemia, currently a source of debate, as well as the complex cascade of biomolecular events as a result of the unique pathophysiology in this disease will pave the way for further neuroprotective strategies to be developed to attenuate the physiological consequences of surgical decompression and augment its benefits.

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“…It is possible to observe the presence of abnormal bony outgrowths (ostephytes) inside the FT, which theoretically can produce lesions to the vertebral artery, vein, and the sympathetic plexus (Strek et al, 1998). The external pressure generated by the degenerative changes in the cervical spine, can produce compressión of the vertebral artery (Cockerill et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variations of the Foramen Transversarium in Cervical Vertebrae

2017

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MOLINET, G. M.; ROBLES, F. P.; & ROA, I. Anatomical variations of the foramen transversarium in cervical vertebrae. Int. J. Morphol., 35(2):719-722, 2017. SUMMARY:The cervical vertebrae are recognized mainly by the presence of the foramen transversarium, which is crossed by the vertebral artery and vein, accompanied by sympathetic fibers. The main objective of this study was to observe and describe the anatomy and variations in the foramen transversarium. 121 cervical vertebrae were analyzed, including the macroscopic characteristics, shape and diameter and presence of the foramen transversarium, as well as the accessory foramen transversarium. All cervical vertebrae presented the foramen transversarium, with a mean diameter of 5.60 mm and a mean diameter of 4.40 mm on the right and 5.92 mm -5.56 mm on the left, respectively. With regard to shape classification according to Taitz et al. (1978), 90.08 % presented the same shape on both sides, and 9.91 % had different shapes. The presentation of the different shapes was as follows: shape 1 41.32 %; shape 2 4.13 %; shape 3 18.8 %; shape 4 14.04 %; and shape 5 12.39 %. Regarding the presence of accessory foramen transversarium, 17.35 % of the vertebrae presented it, 66.6 % unilateral, 57.14 % on the right side and 42.85 % on the left side. Osteophytes, were presented in 5.7 %. The anatomical knowledge of these variations is useful for spine surgeons in preoperative planning and for preventing vertebral vessel and sympathetic nerve injuries during cervical surgical approaches.

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A possible correlation between vertebral artery insufficiency and degenerative changes in the cervical spine

Cited by 47 publications

References 15 publications

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

Pathobiology of cervical spondylotic myelopathy

Anatomical Variations of the Foramen Transversarium in Cervical Vertebrae

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