The Anatomic Relation Among the Nerve Roots, Intervertebral Foramina, and Intervertebral Discs of the Cervical Spine

Abstract

This study demonstrated the anatomy of the nerve roots, rootlets, and intervertebral foramina, and may aid in understanding the pathology of cervical radiculopathy. The presence of intradural connections between dorsal nerve roots and the relation between the course of the nerve root and the intervertebral disc may explain the clinical variation of symptoms resulting from-nerve root compression in the cervical spine. To perform cervical foraminotomy for cervical radiculopathy, it is necessary to understand the detailed anatomy of the intervertebral foramina thoroughly.

Complications of transpedicular screw fixation in the cervical spine

“…Previous reports on the use of cervical pedicle screws have focused on anatomical specialties of the cervical spine [6,9,14,17,18], biomechanical issues [6,10,15] and surgical techniques [8,11,12]. Few publications dealt with the complications attributed to this surgical technique [1,8].…”

“…This can be explained by anatomical facts. The diameter of the pedicles C3 and C4 are the smallest within the cervical spine [6,9,14,17,18]. Karaikovic et al [9] found that 75% of the pedicles C3 and 36% of the pedicles C4 are smaller than 4 mm.…”

“…Although all screws were inserted by otherwise experienced spine surgeons, we have to confess that there is a high potential for insertion failure at the beginning due to the different anatomy and the considerable transverse pedicle angle in the cervical spine as compared to the thoracic and lumbar spine [6,9,14,17,18].…”

Cervical cages placed bilaterally in the facet joints from a posterior approach significantly increase foraminal area

“…The cervical neural foramen can be decompressed using a direct or indirect approach [4]. Direct decompression can be achieved via anterior cervical discectomy and fusion, transvertebral anterior cervical foraminotomy or posterior foraminotomy [1,4,5].…”

“…Direct decompression can be achieved via anterior cervical discectomy and fusion, transvertebral anterior cervical foraminotomy or posterior foraminotomy [1,4,5]. The anterior approach provides both direct and indirect decompression with direct resection of degenerative tissue and disc height restoration [1,4].…”