The Neural Sulcus of the Cervical Vertebrae: A Review of Its Anatomy and Surgical Perspectives.

Neil Joshi,Neil Klinger,Dia R Halalmeh,Marc D Moisi,R Shane Tubbs

doi:10.7759/cureus.6693

Abstract

The neural sulcus is a bony channel that spans the transverse process in the subaxial cervical spine. It is located between the anterior and posterior tubercles on either side of the transverse foramen, housing the spinal nerve as it passes through the intervertebral foramina. Although numerous studies have evaluated the anatomy of the cervical spine, very little data on detailed anatomy of the neural sulcus and its implication in cervical spine surgery exist. Here, we review the anatomy of the neural sulcus and surgical considerations. The neural sulcus has important surgical implications, and knowledge of its anatomy is important in considering and planning posterior cervical segmented instrumentation. This increases the ability of the neurosurgeon to choose the best suitable surgical approach to the subaxial cervical spine, allowing good outcomes for the patient.

Highlights

BackgroundThe typical vertebral body consists of a body and a posterior vertebral arch with several processes for muscular and articular attachments
The cervical vertebrae are characterized by the presence of round foramen, perforating each transverse process
The foramen transversarium in cervical vertebrae other than the atlas is bounded by the anterior tubercle anteriorly and by the posterior tubercle posteriorly [1,2]

Summary

Introduction

The typical vertebral body consists of a body and a posterior vertebral arch with several processes for muscular and articular attachments. In the subaxial cervical spine, the dorsal and ventral nerve roots exit the vertebral canal via the intervertebral foramen They continue their course laterally by way of the neural sulcus, which extends from the medial border of the pedicle to the lateral end of the transverse process and associated costal process [1,2,3]. The neural sulcus extends from the vertebral canal to the tip of the transverse process with an average length of 1.5-2.0 cm [2] It can be divided into two portions: a “radicular portion” (medial) which houses the spinal nerve and a “portion of the anterior ramus of the transverse process” (lateral). The existence of the neural sulcus clears the transverse foraminal and interforaminal pathways of the vertebral artery by forcing the intervertebral foramina to occupy a more anteromedial position [15]

Conclusions

Disclosures

Veleanu C

10. Sekhon LH