Cervical Spinal Nerves Anatomical Study And Clinical Application

Objective:Based on10cases of male cadaveric neck specimen dissected under the microscope, the thickness of the cervical posterior root are observed and measured. All levels of nerve bundles composition contained on the cervical spinal dorsal root are statistically descripted to explore their clinical significance in the operation. To study the causing factors of spinal nerve roots stuck an atomically in the cervical intervertebral foramen. This research subject can provide anatomy the basis and reference for the regional operation treatment for clinical treatment. To review the clinical manifestations, imaging characteristics, histopathologic features for tumors in the superior cervical spinal cord. To evaluate the curative effect of microsurgery.Methods:The subject apply the10antiseptic cadaveric neck specimens perfused with red silicone, we isolate muscles, expose the cervical vertebral lamina, excise C2-T2spinous process, lamina, yellow ligament and intervertebral joint, and expose dura mater of spinal cord and spinal nerve root. After incision of dura, using vernier caliper (accuracy0.02mm) and ruler (accuracy lmm), the natural splitting of C3-T1segmental cervical dorsal root are observed from microsurgical anatomic opinion. According to the same mothed, in10cases (20sides), the thickness of the C3-T1segments cervical spinal nerve posterior root are observed and measured. The sagittal width and height of the intervertebral foramen and the spinal nerve roots were measured respectively on10(20sides totally) adult cadavers. The data were obtained and the corresponding ratios of spinal nerve roots to intervertebral foramen were processed statistically. We retrospectively studied a series of18patients with tumors in the superior cervical spinal cord of C4or above who were treated by department of neurosurgery, Zhongnan Hospital of Wuhan University from January2010to January2012.Results:The number of the nerve bundles in every section cervical posterior root are almost the same, but the C6segmental cervical dorsal root contain more nerve fascicle, sub-bundles and rootlets than the other roots. The C6segmental nerve bundles are bigger than the other. At the same segment, the posterior root of the C6was the biggest of all posterior roots. An invariable artery was found between the anterior and posterior roots. The ratio of spinal nerve roots to the intervertebral foramen in the rations in C5-C7were higher than in C3-C4. Of all patients in this group, most of them with upper limbs weakness or numbness (13cases), neck discomfort (7cases), cervical radicular pain (10cases), limbs paralysis (6cases), muscle atrophy (5cases), dysuresia (3cases) as initial symptoms. Another one case showed respiratory paralysis as the first symptom. Pathology reports in the surgical operation showed:Schwannomas in8cases, meningiomas in3cases, astrocytomas in2cases, ependymoma in1case, hemagioblatoma in1case, and lipoangioma in1case. After average (12.3±1.5) months of follow-up after surgical treatment, the patients’clinical symptoms were significantly ameliorated.Conclusion:The C6segment cervical spinal posterior root contain more nerve fascicle, sub-bundles and rootlets, so this segment is most easily damaged in the cervical spinal cord operation.The C6segment cervical spinal anterior and posterior roots are the thickest, so this segment is the most important in all segment cervical spinal cords.It is suggested that the spinal nerve roots lesions were not only related closely to the stenosis of intervertebral foramen, but also related to the external diameter of the spinal nerve roots and the soft tissue in spinal nervous canal. The radical microneurosurgery treatment for intradullary tumor in the superior cervical spinal cord has been increasingly improved and the ration of tall resection has been heightened. MRI is the best examination methods for the diagnosis of tumors in the superior cervical spinal cord.