Study of the origin and distribution of blood vessel of longus colli and their clinical significance

English Keywords:Longus colli  Anterior cervical spine surgery  Origin of blood vessels

English Abstract:

  【Abstract】 Objectives: To explore the potential clinical significance of longus colli(LCo) through analyzing the origin and distribution of the vessels of LCo. Methods: An anatomical study was performed on 12 embalmed adult cadaveric specimens(8 males, 4 females). Blood vessels were visualized with latex perfusion. The origin of blood vessles of LCo, and the entry point, distribution and end point of the blood vessels of each branch at LCo were recorded. The lengths between entry point/end point and the medial border of the ipsilateral and horizontal LCo were measured separately, and the corresponding vertebral body or intervertebral disc segment was recorded to analyze the clinical significance. Results: According to anatomical position, the relationship between the vessels and LCo was divided into: (1) The vessels passing over LCo(upper, middle, and lower branches) were mainly from the inferior thyroid artery and thyrocervical trunk. The entry point of upper branch was distributed at C6-C7 vertebrae, with a distance of 16.80±9.87mm to the medial border of LCo. Running a superomedial course obliquely, the vessels ended at 11.75±8.93mm from the medial border of LCo at C5-C6 vertebrae. The entry point of the middle branch was distributed at C6-T1 vertebrae at a distance of 16.62±5.96mm from the medial border of LCo. Running a superomedial course obliquely, with occasional bifurcation, 66.7% of the vessels ended at the medial border of LCo and 33.3% at 7.87±4.27mm from the medial edge of LCo at C4-C7. The entry point of lower branch was distributed at C6-T2, 15.65±4.47mm away from the medial border of LCo. It sent out 1 to 4 branches, forming a mesh structure, and ended at the medial side of C6-T3 LCo or ran down into the lateral pericardial adipose tissue to form a vascular network; (2) The intramuscular vessels of LCo were the continuation of the upper surface vessels after entering the muscle, which were muscle-nourishing blood vessels that passing through the deep part of the lower muscle and entering the vertebral body; (3) The blood vessels on the lower surface of LCo were distributed between the lower surface of the muscle and the vertebral body. The blood vessels of C5 and C6 were derived from the vertebral artery and inferior thyroid artery, and those of C7 and T1 were derived from the deep carotid artery. The blood vessels were twisted in distribution, forming blood vessel clusters into the vertebral body, and the distances from different vertebral planes from C3-T1 to the medial border of the LCo were 1.85-4.60mm, 1.89-2.61mm, 2.60-7.27mm, 1.19-7.95mm, 2.06-8.61mm and, 2.47-8.08mm, respectively. Conclusions: The blood vessels of LCo is regular in distribution, which branches into upper, middle, and lower branches at the surface of LCo and mostly end at the nutrient foramina on both sides at the upper 1/3 of the vertebral body under the lower surface of LCo. In anterior cervical spine surgery, avoiding dissecting LCo above the vertebral body or below the upper endplate can reduce the probability of bleeding and postoperative cervical hematoma formation.