Abstract
BackgroundThe anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.MethodsThe paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.ResultsThe displacement of the C5, C6, C7, and C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p < 0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.ConclusionsCervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.
Highlights
The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied
Grimes et al [3] found that the lumbar extraforaminal ligaments (EFLs) significantly increased the ability of nerve roots to resist external traction and that this ability
To explore the mechanism of different types of brachial plexus nerve root injury, we provide an objective biomechanical basis for the clinical diagnosis and treatment of related conditions
Summary
The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. Many different ligamentous structures in the spinal canal protect the nerve roots by preventing them from being pulled out from the spinal cord [2]. Grimes et al [3] found that the lumbar extraforaminal ligaments (EFLs) significantly increased the ability of nerve roots to resist external traction and that this ability. Abduction injury of the upper limb often causes damage to the nerve roots or trunk of the brachial plexus. Brachial plexus injury is one of the most common peripheral nerve injury diseases, and one of the disabling diseases. It has a huge physical and mental impact and burden on patients, and brings a serious burden to the families and society of the patients.
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