Longus Colli and Vertebral Artery Guide Safety of Cervical Spine Surgery

Adisak  Kasemassawachanont; Sanan  Cheewadhanaraks; Woratee  Dacharux; Eve Mon  Oo; Chairat  Turbpaiboon; Somyot  Wunnasinthop; Supin  Chompoopong

doi:10.33192/Smj.2022.60

Authors

Adisak Kasemassawachanont Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Sanan Cheewadhanaraks Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Woratee Dacharux Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Eve Mon Oo Department of Anatomy, University of Medicine Taunggyi
Chairat Turbpaiboon Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Somyot Wunnasinthop Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University/Bone and joint units, Thonburi Hospital
Supin Chompoopong Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/Smj.2022.60

Keywords:

Cervical vertebra, uncinate process, anterior cervical surgery, vertebral artery

Abstract

Objective: To improve the safety of the anterior cervical vertebral surgical approach, MRI and CT have been used and the distances between the medial borders of the longus colli (LC) to expose the uncinated process (UP) have been reported. The anatomic parameters of the LC and vertebral artery (VA) were considered here in relation to the UP to minimize complications.
Materials and Methods: Data were obtained from 60 Thai adult skeletons and 20 embalmed cadavers. Direct measurements of the dry cervical vertebrae were performed using digital Vernier calipers, while computer imaging analysis was used for the cadaveric measurements after capturing the images.
Results: No significant difference was noted in the inter-UP distance between the dry and cadaveric cervical measurements. The average UP width was 6.7 ± 0.2 mm. The average distance from the tip of the UP to the VA was 2.6 ± 0.1 mm. The calculated distance from the LC to the UP which derived from the inter-UP distance and the distance between the LC increased from C2 to C7 with an average distance of 11.9 ± 0.3 mm.
Conclusion: Within a distance of 11.9 ± 0.3 mm from the medial border of the LC, UP can be identified. Dissecting at a distance less than 10 mm posterior, 5–6 mm lateral and superior to the base of the UP can avoid VA injury and optimize the safety of the anterior cervical vertebral surgical approach.

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