Clinical significance of the cervical sympathetic trunk in anterior lateral cervical surgical approach
NIE Zheng, JIANG Heng, SHAN Jian-lin
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (4) : 367-370.
Clinical significance of the cervical sympathetic trunk in anterior lateral cervical surgical approach
Objective To understand the anatomical relationship between sympathetic nerve and the cervical fascia，and provide a more reliable method for avoiding sympathetic trunk injury in the anterolateral cervical surgery. Methods 42 specimens of Faure Marin's fixed adult cadavers were divided into two groups, with 30 in the first group and 12 in the second group. The spatial relationship between the sympathetic trunk and the superficial layer of the prevertebral fascia（Alar fascia）and the degree of connection were investigated. In the second group，relationship between the cervical sympathetic trunk and the carotid sheath was observed. Results In the first group, the distance between the cervical sympathetic trunk and the centrum of the vertebral body at the 7 cervical vertebra was the smallest, about 20 mm. In all the specimens, the cervical sympathetic trunk was closely adhered to the Alar fascia above the seventh cervical vertebrae, and some even could be seen as being wrapped in the superficial fascia of the cervical fascia. It was not easy to be separated from the Alar fascia. The cervical sympathetic trunk was also pulled apart together when the Alar fascia was pulled outward in the second group. In all specimens the cervical sympathetic trunk were tightly adhered to the posterior aspect of the carotid sheath. Conclusion The cervical sympathetic trunk is tightly adhered to the deep surface of prevertebral fascia and can be pulled away naturally with the Alar fascia. In the anterolateral cervical approach，there is no necessity to identify or separate sympathetic trunk. The cervical sympathetic trunk can be effectively protected by pulling the superficial cervical fascia merely.
Anterolateral cervical spine surgical approach; / Cervical fascia; / Cervical sympathetic trunk; / Anatomy
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