Anatomical observation and measurement of the thoracic extra-foramina ligaments 

ZHANG Ru-sen, ZHAO Qing-hao, ZHAO Jian-jun, ZHU Wei-jia, MA Run-xun, LI Qing-chu, LIU Ze-zheng

Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (3) : 241-245.

Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (3) : 241-245. DOI: 10.13418/j.issn.1001-165x.2020.03.001

Anatomical observation and measurement of the thoracic extra-foramina ligaments 

  • ZHANG Ru-sen, ZHAO Qing-hao, ZHAO Jian-jun, ZHU Wei-jia, MA Run-xun, LI Qing-chu, LIU Ze-zheng
Author information +
History +

Abstract

Objective To proceed the anatomical research on the ligaments in the exit regions of the T1~12 intervertebral foramina and to discuss its possible clinical significance.   Methods    Two hundred and forty T1~12 intervertebral foramina from 10 adult cadavers were dissected and observed. All the ligaments that appeared were identified. The number, morphology, distribution, starting and ending position and the adjacency of the ligaments were observed and recorded. The length, width and thickness of each ligament were measured by vernier calipers.    Results    564 extra-foramina ligaments were found in 229 intervertebral foramina, while there were no ligaments in the remaining 11 intervertebral foramina. The occurrence rate of extra-foramina ligaments was 95.42%. There were two types of ligaments: radiating ligaments accounting for 24.11%(136 cases) and transverse ligaments accounting for 75.89% (428 cases). It was relatively common for the radiating ligaments in the segment of T1 and T9~12, but sparse in the segment of T2~8. Of these, 43.44% ligaments (245 cases) were located in the anterior part of the exit regions of the intervertebral foramina, 39.89% ligaments (225 cases) in the posterior, 11.35% ligaments (64 cases) in the upper part, 5.32% ligaments (30 cases) in the bottom part.   Conclusions    There are two types of ligaments in the exit regions of thoracic intervertebral foramina. The radiating ligament may be a kind of protective mechanism against traction, which can fix and protect the spinal nerve. Transverse ligaments may be one of the potential causes of rib or chest pain after thoracic compression fracture.

Key words

Extra-foramina ligaments /   /   / T1~12 intervertebral foramina /   /   / Anatomy /   /   / Non-midline pain

Cite this article

Download Citations
ZHANG Ru-sen, ZHAO Qing-hao, ZHAO Jian-jun, ZHU Wei-jia, MA Run-xun, LI Qing-chu, LIU Ze-zheng. Anatomical observation and measurement of the thoracic extra-foramina ligaments [J]. Chinese Journal of Clinical Anatomy. 2020, 38(3): 241-245 https://doi.org/10.13418/j.issn.1001-165x.2020.03.001

References

[1]  Behrbalk E, Uri O, Folman Y, et al. Staged correction of severe thoracic kyphosis in patients with multilevel osteoporotic vertebral compression fractures[J]. Global Spine J, 2016, 6(7): 710-720.
[2]  Kendler DL, Bauer DC, Davison KS, et al. Vertebral fractures: clinical importance and management[J]. Am J Med, 2016, 129(2): 221.
[3]  Black DM, Cummings SR, Karpf DB, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group[J]. Lancet, 1996, 348(9041): 1535-1541.
[4] Patel U, Skingle S, Campbell GA, et al. Clinical profile of acute vertebral compression fractures in osteoporosis[J]. Br J Rheumatol, 1991, 30(6): 418-421.
[5] Gibson JE, Pilgram TK, Gilula LA. Response of nonmidline pain to percutaneous vertebroplasty[J]. AJR Am J Roentgenol, 2006, 187(4): 869-872.
[6] Chung SK, Lee SH, Kim DY, et al. Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture: the role of vertebroplasty[J]. J Spinal Disord Tech, 2002, 15(6): 461-468.
[7] Marré B, Ballesteros V, Martínez C, et al. Thoracic spine fractures: injury profile and outcomes of a surgically treated cohort[J]. Eur Spine J, 2011, 20(9): 1427-1433.
[8] Choi HJ, Yang HJ, Lee SH, et al. The effect of vertebroplasty on costal pain related to osteoporotic thoracic compression fractures in elderly patients[J]. Korean J Spine, 2012, 9(2): 98-101.
[9] Kraan GA, Hoogland PV, Wuisman PI. Extraforaminal ligament attachments of the thoracic spinal nerves in humans[J]. Eur Spine J, 2009, 18(4): 490-498.
[10]Robertson DJ, Von Forell GA, Alsup J, et al. Thoracolumbar spinal ligaments exhibit negative and transverse pre-strain[J]. J Mech Behav Biomed Mater, 2013, 23(7): 44-52.
[11]Jiang H, Raso JV, Moreau MJ, et al. Quantitative morphology of the lateral ligaments of the spine. Assessment of their importance in maintaining lateral stability[J]. Spine (Phila Pa 1976), 1994, 19(23): 2676-2682.
[12]Ibrahim AF, Darwish HH. The costotransverse ligaments in human: a detailed anatomical study[J]. Clin Anat, 2005, 18(5): 340-345.
[13]Akdemir G. Thoracic and lumbar intraforaminal ligaments[J]. J Neurosurg Spine, 2010, 13(3): 351-355.
[14]刘贞明, 曲永松, 安月勇, 等. 成人胸椎间孔韧带的解剖学观测[J]. 中国临床解剖学杂志, 2011, 29(1): 42-44.
[15]Zhao Q, Zhong E, Shi B, et al. The morphology and clinical significance of the intraforaminal ligaments at the L5-S1 levels[J]. Spine J, 2016, 16(8): 1001-1006.
[16]Qian Y, Qin A, Zheng MH. Transforaminal ligament may play a role in lumbar nerve root compression of foraminal stenosis[J]. Med Hypotheses, 2011, 77(6): 1148-1149.
[17]Kraan GA, Delwel EJ, Hoogland PV, et al. Extraforaminal ligament attachments of human lumbar nerves[J]. Spine (Phila Pa 1976), 2005, 30(6): 601-605.
[18]Zhong E, Zhao Q, Shi B, et al. Morphology and possible clinical significance of the radiating extraforaminal ligaments at the L1-L5 levels[J]. Spine (Phila Pa 1976), 2017, 42(18): 1355-1361.
[19]Min JH, Kang SH, Lee JB, et al. Anatomic analysis of the transforaminal ligament in the lumbar intervertebral foramen[J]. Neurosurgery, 2005, 57(1 Suppl): 37-41.
[20]钱宇, 范顺武, 顾传龙, 等. 下腰椎椎间孔内韧带的形态学研究[J]. 中华骨科杂志, 2003, 23(12): 761-763.
[21]张勇, 余克强, 李义凯, 等. 腰椎间孔韧带的解剖观测及其临床意义[J]. 中国临床解剖学杂志, 2002, 20(2): 112-114.
[22]宋鹤九, 孙树功, 赵林昌, 等. 腰部椎间孔韧带的观测[J]. 解剖学杂志, 1996, 19(6): 473-475.
[23]Arslan M, Acar HI, Comert A. Cervical extraforaminal ligaments: an anatomical study[J]. Surg Radiol Anat, 2017, 39(12): 1377-1383.
[24]Lohman CM, Gilbert KK, Sobczak S, et al. 2015 Young investigator award winner: cervical nerve Root displacement and strain during upper limb neural tension testing: part 2: role of foraminal ligaments in the cervical spine[J]. Spine (Phila Pa 1976), 2015, 40(11): 801-808.
[25]Kraan GA, Smit TH, Hoogland PV. Extraforaminal ligaments of the cervical spinal nerves in humans[J]. Spine J, 2011, 11(12): 1128-1134.
[26]Shi B, Zheng X, Min S, et al. The morphology and clinical significance of the dorsal meningovertebra ligaments in the cervical epidural space[J]. Spine J, 2014, 14(11): 2733-2739.

Accesses

Citation

Detail

Sections
Recommended

/