Morphological characteristics of the first denticulate ligament and its clinical significance

doi:10.13418/j.issn.1001-165x.2021.01.002

Chinese Journal of Clinical Anatomy ›› 2021, Vol. 39 ›› Issue (1) : 7-11. DOI: 10.13418/j.issn.1001-165x.2021.01.002

Du Xinru¹, Kong Xiangyu², Guo Sen², Wang Jiajia³, Liu Hongwei⁴, Ma Quan², Liu Yingdong²

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Abstract

Objective　To observe the anatomical structure of the first denticulate ligament at the craniocervical junction and to discuss its clinical significance. Methods Eighteen cranial-neck specimens were dissected and were stripped to observe the structure of the first denticulate ligament. Its starting and finishing, adjacency, course and its morphology were observed. The histological characteristics of the ligament was detected by HE staining.　Results　The first denticulate ligament were found in left and right side of all specimens (occurrence rate: 100%), with the membrane type in 9 cases (accounting for 50%); dense type in 4 cases (accounting for 22.2%); loose type in 5 cases (accounting for 27.8%). The first denticulate ligament was located laterally to the superior medulla oblongata, the fibers converged outwards and upward in a long triangle, crossing behind the vertebral artery and ending in the epidural and fusing with the dura mater. The attachment part on the spinal cord was located between the anterior root and posterior root of the spinal nerve, the distal part was integrated with the 2nd ~ 8th dentate ligament, and the proximal part reached the level of the medulla oblongata. Histological result showed that the denticulate ligament was composed of collagen fibers. Conclusions　The first denticulate ligament plays an important role in maintaining the stability of the spinal cord. Subarachnoid space is divided into a front part and a back part by denticulate ligament. Cerebrospinal fluid pressure imbalance can lead to different stress on the anterior and posterior parts of the spinal cord. And the anterior spinal cord may be subjected to higher pressure stimulation to aggravate or induce the injury of the anterior horn cells of the spinal cord and the corticospinal tract, which may be one of the anatomical factors leading to amyotrophic lateral sclerosis (ALS).

Key words

Denticulate ligament / 　Amyotrophic lateral sclerosis;　Craniocervical junction

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Du Xinru, Kong Xiangyu, Guo Sen, Wang Jiajia, Liu Hongwei, Ma Quan, Liu Yingdong. Morphological characteristics of the first denticulate ligament and its clinical significance[J]. Chinese Journal of Clinical Anatomy. 2021, 39(1): 7-11 https://doi.org/10.13418/j.issn.1001-165x.2021.01.002

References

[1] 刘帆, 孙博, 苗延巍, 等. 肌萎缩侧索硬化症MRI研究进展[J]. 国际医学放射学杂志, 2019, 42(3): 308-311.DOI: CNKI:SUN:GWLC.0.2019-03-013.
[2] 王琳琳, 刘睿, 张俊霞. 神经退行性疾病相关微 RNA 的研究进展[J].医学综述, 2017, 23(6): 1041-1046, 1051. DOI: 10.3969/j.issn.1006-2084.2017.06.001.
[3] 宋彬彬, 刘小鹏, 张翼, 等. 溶酶体病变与肌萎缩侧索硬化症[J]. 脑与神经疾病杂志, 2019, 27(1): 58-62. DOI: CNKI:SUN:LYSJ.0.2019-01-014.
[4] Yamada M, Furukawa Y, Hirohata M. Amyotrophic lateral sclerosis: frequent complications by cervical spondylosis[J]. J Orthop Sci, 2003, 8(6): 878-881. DOI 10.1007/s00776-003-0712-0.
[5] Yoshor D，Klugh 3rd A， Appel SH, et al. Incidence and characteristics of spinal decompression surgery after the onset of symptoms of amyotrophic lateral sclerosis[J]. Neurosurgery, 2005, 57(5): 984-989. DOI: 10.1227/01.NEU.0000180028.64385.d3.
[6] 马帅, 初明. 脑脊液相位对比磁共振成像法在退行性颈椎病的临床应用[J]. 医学综述, 2019, 25(3): 561-565. DOI: 10.3969/j.issn.1006-2084.2019.03.029.
[7] 隋鸿锦, 于胜波, 苑晓鹰, 等. 枕下区结构与硬脊膜联系的解剖学研究[J].中国临床解剖学杂志, 2013, 31 (4): 489-490. DOI:10.13418/j.issn.1001-165x.2013.04.011.
[8] 陈燕春, 刘焕彩, 管英俊, 等. Akt在肌萎缩性脊髓侧索硬化症转基因鼠脊髓中的表达变化及意义[J]. 解剖学杂志, 2014, 37(3): 331-334. DOI: 10.3969/j.issn.1001-1633.2014.03.013.
[9] 俞永林,黄煌渊, 张志玉. 齿状韧带切断在治疗脊髓型颈椎病中的作用[J]. 中国临床神经科学, 1999, 7(1): 36-38.
[10] Tominaga T, Watahe N, Takahashi T, et al. Quantilativeassessment of surgical decompression of the cervical spine with cinephase contrast magnetic resonance imaging[J]. Neurosurgery, 2002, 50(4): 791-795. DOI: 10.1097/00006123-200204000-00020.
[11] Ghobrial GM, Harrop JS. Surgery vs conservative care for cervicalspondylotic myelopathy: nonoperative operative management[J]. Neurosurgery,2015,62 (Suppl l): 62-65. DOI: 10.1227/NEU.000000 0000000816.
[12] Vavasour IM, Meyers SM, Macmillan EL, et al. Increased spinalcord movements in cervical spondylotic myelopathy[J]. Spine J, 2014, 14(10): 2344-2354. DOI: 10.1016/j.spinee.2014.01.036.
[13] 党静霞, 胡芳芳, 靳娇婷. 肌萎缩侧索硬化症的重复电刺激研究[J]. 西安交通大学学报(医学版), 2015, 36(2): 235-240. DOI: 10.7652/jdyxb201502018.
[14] 周乐波, 王雪晶, 丁雪冰, 等. 肌萎缩侧索硬化症患者骨骼肌神经末梢中磷酸化TAR DNA结合蛋白43和泛素的表达[J]. 郑州大学学报(医学版), 2019, 54(2): 227-231. DOI: 10.13705/j.issn.1671-6825. 2018.08.019.
[15] 张高嘉,郭怡菁,袁宝玉. 肌萎缩侧索硬化疾病上运动神经元损害的神经电生理评估进展[J]. 癫痫与神经电生理学杂志, 2019, 28(2): 114-118.