Thoracic and lumbar intraforaminal ligaments

2010 ◽  
Vol 13 (3) ◽  
pp. 351-355 ◽  
Author(s):  
Gökhan Akdemir
Keyword(s):  
Anatomical Study ◽  
Paraspinal Muscles ◽  
Nerve Roots ◽  
En Bloc ◽  
Thoracic And Lumbar Spine ◽  
Human Cadavers ◽  
Band Saw ◽  
Lumbar Spinal ◽  
Intervertebral Foramina ◽  
Ligamentous Attachment

Object The author conducted a study to investigate the anatomy of the intraforaminal ligaments of the thoracic and lumbar nerve roots and describe their anatomical relationships and functional properties. This anatomical study performed on the intervertebral foramina, intraforaminal ligaments, transforaminal ligaments, and nerve roots of the thoracic and lumbar spine was performed in human cadavers. Methods The foraminal anatomy was studied in 11 whole cadavers (5 females, 6 males) previously prepared with formaldehyde, whose ages at the time of death ranged from 16 to 71 years. The thoracic and lumbar spinal columns were separated from the cervical and sacral segments en bloc using an electric band saw. The paraspinal muscles and their attachments were removed by sharp and meticulous dissection, and the thoracic and lumbar intervertebral foramina were examined under a surgical microscope. The intervertebral foraminal ligaments and nerve roots were exposed. The foraminal contents were identified and studied in detail. The intraforaminal ligaments were stained using H & E to determine ligamentous fiber. Results Intraforaminal ligaments connect the periosteum and transforaminal ligaments to the nerve root sleeves and vessels within the fatty areolar tissue. Histologically, the ligamentous attachment of the nerve roots within the foramina consists of adipose and connective tissue. Conclusions The nerve roots are surrounded by intraforaminal ligaments, which may act in conjunction with the dura and periosteum to protect the nerve roots mechanically.

Biomechanics of the lumbar spinal nerve roots and the first sacral root within the intervertebral foramina

1989 ◽  
Vol 11 (3) ◽  
pp. 221-225 ◽  
Author(s):  
F. de Peretti ◽  
J. P. Micalef ◽  
A. Bourgeon ◽  
C. Argenson ◽  
P. Rabischong
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Lumbar Spinal ◽  
Intervertebral Foramina

Total cervical spondylectomy for primary osteogenic sarcoma

2002 ◽  
Vol 97 (3) ◽  
pp. 386-392 ◽  
Author(s):  
Zvi R. Cohen ◽  
Daryl R. Fourney ◽  
Rex A. Marco ◽  
Laurence D. Rhines ◽  
Ziya L. Gokaslan
Keyword(s):  
Cervical Spine ◽  
Osteogenic Sarcoma ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Nerve Roots ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
Content Type ◽  
Bloc Spondylectomy ◽  
Thoracic And Lumbar Spine

✓ The authors describe a technique for total spondylectomy for lesions involving the cervical spine. The method involves separately staged anterior and posterior approaches and befits the unique anatomy of the cervical spine. The procedure is described in detail, with the aid of radiographs, intraoperative photographs, and illustrations. Unlike in the thoracic and lumbar spine—for which methods of total en bloc spondylectomy have previously been described—a strictly en bloc resection is not possible in the cervical spine because of the need to preserve the vertebral arteries and the nerve roots supplying the upper limbs. Although the resection described in this case is by definition intralesional, it is oncologically sound, given the development of effective neoadjuvent chemotherapeutic regimens for osteosarcoma.

scholarly journals A METHOD FOR REMOVAL OF BRAIN, BRAIN STEM WITH SPINAL CORD AS ONE UNIT FROM HUMAN CADAVERS FOR ANATOMICAL STUDY AND MUSEUM PURPOSES

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Subhash Bhukya ◽  
Merlin R Thomas ◽  
Alok P Acharya ◽  
A Manitombi Devi ◽  
A Banerjee
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cauda Equina ◽  
Anatomical Study ◽  
Spinal Nerve ◽  
Posterior Arch ◽  
Nerve Roots ◽  
Venous Sinuses ◽  
Human Cadavers ◽  
Museum Display

After successful embalming of the 05 human adult cadavers, removals of brain, brain stem with spinal cord were done as a single unit. The removal of bilateral laminectomy of vertebrae helps in viewing of spinal cord with its coverings and spinal nerve roots, dorsal root ganglion and cauda equina. It is followed by removal of vault of skull, squamous part of occipital bone and posterior arch of atlas, helps in viewing of brain, brain stem along with dural sheath and venous sinuses. This approach helps in total removal of brain, brain stem and spinal cord with its covering with large venous sinuses remaining intact however small venous sinuses are sacrificed in this process. The specimen thus obtained can be used for anatomical study and museum display. Keywords: Removal of brain, brain stem, spinal cord, anatomical study.

scholarly journals The Morphology and Possible Clinical Significance of the Intraforaminal Ligaments in the Entrance Zones of the L1-L5 Levels

2018 ◽  
Vol 1 (21;1) ◽  
pp. E157-E165
Author(s):  
Wenhua Huang
Keyword(s):  
Clinical Significance ◽  
Histological Examination ◽  
Cerebrospinal Fluid Leakage ◽  
Clinical Anatomy ◽  
Posterior Aspect ◽  
Inferior Aspect ◽  
Fresh Frozen ◽  
Human Cadavers ◽  
Lumbar Spinal ◽  
Intervertebral Foramina

Background: The extraforaminal ligaments between the L1-L5 lumbar spinal nerves and the tissues surrounding the intervertebral foramina (IVF) have been well studied. However, little research has been performed to describe the local anatomy of the entrance zones at the L1-L5 level. Detailed anatomic studies of the intraforaminal ligaments (IFLs) in the entrance zones at the L1-L5 levels have not been performed. Objectives: The objective of this study is to identify and describe the IFLs in the entrance zones of the L1-L5 IVF and to determine their possible clinical significance. Study Design: A dissection-based study of 10 fresh-frozen human cadavers. Setting: Guangdong Provincial Key Laboratory of Medical Biomechanics in Anatomy Department of Southern Medical University. Methods: Eighty L1-L5 IVF from 10 fresh cadavers were studied, and the IFLs in the entrance zones were identified. The quantities, morphologies, origins, insertions, and spatial orientations of the IFLs in the entrance zones of the L1-L5 IVF were observed. The lengths, widths, diameters, and thicknesses of the ligaments were measured using a vernier caliper. Ten intraforaminal radiating ligaments were removed for histological examination. Results: A total of 197 ligaments were identified in the entrance zones of the 80 L1-L5 IVF, including 191 (96.95%) radiating ligaments and 6 (3.05%) transforaminal ligaments. The thickest ligaments were observed at the L3-L4 IVF. The lengths of the ligaments varied from 0.59 to 11.92 mm. There were 66 (33.50%) ligaments in the superior aspect of the entrance zone of the IVF, 58 (29.44%) ligaments at the anterior aspect, 43 (21.83%) ligaments at the posterior aspect, and 30 (15.23%) ligaments at the inferior aspect. The morphologies of the IFLs were divided into 2 types: the strap type and the trabs type. Histological examination of the meningovertebral ligaments revealed fibrous connective tissue. Limitations: The major limitation of this study is the lack of actual clinical data from live patients. In addition, future medical biomechanics experiments are expected to contribute more objective data on the strength of the IFLs. Conclusions: In the lumbar spine, IFLs are common structures in the entrance zones of the L1-L5 IVF, and radiating ligaments are more likely to be present. Key words: Clinical Anatomy, microdissection, intraforaminal ligament, the entrance zone, L1-L5 intervertebral foramen, endoscopic spinal adhesiolysis, sacral hiatus, cerebrospinal fluid leakage, dural laceration

The Volar Distal Radioulnar Portal in Wrist Arthroscopy: An Anatomical Study

2020 ◽  
Author(s):  
Francisco J. Lucas ◽  
Vicente Carratalá ◽  
Ignacio Miranda ◽  
Cristobal Martinez-Andrade
Keyword(s):  
At Risk ◽  
Ulnar Nerve ◽  
Surgical Techniques ◽  
Anatomical Study ◽  
Neurovascular Bundle ◽  
Wrist Arthroscopy ◽  
Iatrogenic Injuries ◽  
Flexor Carpi Ulnaris ◽  
Human Cadavers ◽  
Triangular Fibrocartilage

Abstract Background Advances in wrist arthroscopy and the emergence of novel surgical techniques have created a need for new portals to the wrist. The aim of this study was to define and verify the safety of the volar distal radioulnar (VDRU) portal. Description of the Technique The VDRU portal is located ∼5 to 10 mm proximal to the proximal wrist crease, just on the ulnar edge of flexor carpi ulnaris tendon and radial to the dorsal cutaneous branch of the ulnar nerve. The ulnar styloid marks the distal point of the portal. Methods An anatomical study was performed on 12 upper extremity specimens of 6 human cadavers. Iatrogenic injuries of neurovascular structures potentially at risk were assessed, and the distance from the portal to these structures was measured. Results No iatrogenic injuries of the structures at risk occurred. Mean distances from the VDRU portal to the ulnar neurovascular bundle, the radial branch of the dorsal sensory branches of the ulnar nerve (DSBUN), and the ulnar branch of the DSBUN were 9.29 ± 0.26 mm, 8.08 ± 0.25 mm, and 10.58 ± 0.23 mm, respectively. There were no differences between left and right wrists. The distances from the VDRU portal to the ulnar neurovascular bundle and the ulnar branch of the DSBUN were significantly shorter in women; this distance was not less than 7 mm in any case. Conclusions The VDRU portal is safe, reproducible, and facilitates the implementation of various techniques related to triangular fibrocartilage complex pathology.

scholarly journals Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

2021 ◽  
Author(s):  
Sergey Dydykin ◽  
Friedrich Paulsen ◽  
Tatyana Khorobykh ◽  
Natalya Mishchenko ◽  
Marina Kapitonova ◽  
...  
Keyword(s):  
Prone Position ◽  
Anatomical Study ◽  
Structural Features ◽  
Posterior Mediastinum ◽  
Visual Navigation ◽  
Anatomical Landmarks ◽  
Video Assisted ◽  
Before And After ◽  
Human Cadavers ◽  
The Right

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

Transurethral en bloc resection of bladder tumor with a dual channelized flexible cystoscope using an Impact Shooter: Preliminary results in human cadavers embalmed by Thiel’s model

2017 ◽  
Vol 16 (3) ◽  
pp. e107-e109
Author(s):  
S. Morizane ◽  
T. Maeda ◽  
R. Nishikawa ◽  
M. Honda ◽  
Y. Ikebuchi ◽  
...  
Keyword(s):  
Bladder Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Preliminary Results ◽  
Flexible Cystoscope ◽  
Human Cadavers

COMPREHENSIVE ANATOMICAL STUDY OF VARIATIONS IN LINGUAL AND FACIAL ARTERIES IN ADULT CADAVERS FOR SURGICAL PRACTICE

2021 ◽  
pp. 69-70
Author(s):  
Ramitha Enakshi Kumar. S ◽  
P. Vahini
Keyword(s):  
Carotid Endarterectomy ◽  
Plastic Surgery ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Malignant Tumours ◽  
Surgical Practice ◽  
Hospital Acquired Infections ◽  
The Face ◽  
Human Cadavers ◽  
Hospital Acquired

Objective: The objective of this study is to comprehensively put forth the anatomical variations in the origin and course of lingual and facial arteries found in adult cadavers. Methods: Ten human cadavers were dissected and studied for variations from the norm regarding facial and lingual arteries . Results: 80% of the cadavers displayed classical origin and course of the arteries. There was a deviation from normal regarding origin of the arteries in 20% of the cadavers. Meanwhile, abnormality in the course amounted to 10%. Conclusion: In 20% of cadavers, there were variations in origin of facial and lingual arteries , meanwhile, changes in the course of the stated arteries is 10%. These variations prove to be of signicance to surgeons to prevent mishaps and hospital acquired infections, while performing carotid endarterectomy, intra-arterial catheterizations, plastic surgery of the face and resection of malignant tumours.

A refined method of en bloc open-door laminoplasty for resection of intradural spinal tumors in the thoracic and lumbar spine

2020 ◽  
Author(s):  
Hiroaki Sameda ◽  
Jun Shinbo ◽  
Yukio Someya ◽  
Sumio Ikenoue ◽  
Kan Takase ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Tumors ◽  
Open Door ◽  
En Bloc ◽  
Refined Method ◽  
Thoracic And Lumbar Spine

scholarly journals Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

2014 ◽  
Vol 72 (10) ◽  
pp. 782-787 ◽  
Author(s):  
Leonor Garbin Savarese ◽  
Geraldo Dias Ferreira-Neto ◽  
Carlos Fernando Pereira da Silva Herrero ◽  
Helton Luiz Aparecido Defino ◽  
Marcello H. Nogueira-Barbosa
Keyword(s):  
Spinal Stenosis ◽  
Cauda Equina ◽  
Intervertebral Discs ◽  
Observer Agreement ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Lumbar Spinal

To evaluate the association of redundant nerve roots of cauda equina (RNRCE) with the degree of lumbar spinal stenosis (LSS) and with spondylolisthesis. Method After Institutional Board approval, 171 consecutive patients were retrospectively enrolled, 105 LSS patients and 66 patients without stenosis. The dural sac cross-sectional area (CSA) was measured on T2w axial MRI at the level of L2-3, L3-4 and L4-5 intervertebral discs. Two blinded radiologists classified cases as exhibiting or not RNRCE in MRI. Intra- and inter-observer reproducibility was assessed. Results RNRCE were associated with LSS. RRNCE was more frequent when maximum stenosis<55 mm2. Substantial intra- observer agreement and moderate inter-observer agreement were obtained in the classification of RNRCE. Spondylolisthesis was identified in 27 patients and represented increased risk for RRNCE. Conclusion LSS is a risk factor for RNRCE, especially for dural sac CSA<55 mm2. LSS and spondylolisthesis are independent risk factors for RNRCE.

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