Anatomical basis and clinical significance of cervical dorsal rami nerve and cervical sympathetic trunk caused cervical disk diease

【Objectives】To study the anatomic characteristics of cervical sympathetic trunk and cervical dorsal rami nerve and their anatomic relationship with the adjacent tissues of the cervical vertebrae in order to provide anatomic basis for the diagnosis and treatment of the cervical nerve compression syndrome at external intervertebral foremen.【Methods】Both sides of 28 Chinese adult cadavers were dissected to observe the anatomic relationship of cervical sympathetic trunk and cervical dorsal rami nerve with the adjacent tissues.The distance between the tendinous decussate origins of the scalenus anticus,the external edges of the tendinous girdles of the musculus longus capitis and the musculus longus colli and the cervical sympathetic trunk was measured.【Rusults】The C1 dorsal ra-mus passed between atlas and occipital bone.The medial branch of C2 dorsal ramus(the greater occipital nerve) passed through the osteofibruos aperture near the superior nuchal line and spreaded across the top of the skull.After arising outside their respective intervertebral foramina,C1-8 dorsal rami passed through osteo-fibruos aperture,entered the osteo-fibruos canal,passed through the tendious decussating fibers of the posterior muscles of neck and then supplied the cervical zygapophysial joints,the nuchal muscles and the occipital skin.The tumescent lymphnodes were foud around the superior cervical sympathetic ganglia.The inferior extremity of the inferior cervical ganglia(stellate ganglia) was adjacent to the first costovertebral joint.The tendinous decussating origins of the scalenus anticus and the tendinous girdles of the musculus longus capitis and the musculus longus colli were all tendious tissue.【Conclusions】 The osteo-fibrous apertures,osteo-fibrous canal and the tendious decussating fibers of the nuchal muscles passed through by cervical dorsal rami are anatomic basis of the cervical dorsal rami compression syndrome.Superior cervical sympathetic ganglia,the hyperplastic first costovertebral joint adjacent to the inferior extremity of the inferior cervical ganglia(stellate ganglia),the tendinous decussating origins of the scalenus anticus and tendinous girdles of the musculus longus capitis and the musculus longus colli were the anatomic factors of the cervical sympathetic trunk stimulated at external intervertebral foramen.