A quantitative analysis of the dimensions and content of the vertebral triangle

Abstract

Purpose

The vertebral triangle (VT) located in the root of the neck most commonly contains the vertebral artery (VA), cervical sympathetic chain and certain roots of the brachial plexus. Although other structures have been reported, few studies have reported on the overall content of this space. Based on the current literature, there is a general paucity of anatomical information pertaining to the dimensional anatomy of the VT and specifically the structures related to it. Therefore, this study aimed to quantitatively analyze the size, position, content, and anatomical structures in relation to the vertebral triangle in a South African sample.

Methods

Forty-three VTs were dissected on bodies donated to science. Measurements taken include the dimensions of the triangle, as well as distances between prominent structures and landmarks of the VT. Observations were made on the presence/absence of the varying neurovascular structures within the VT.

Results

Mean height was 30.1 ± 1.51 mm (R) and 32.9 ± 1.78 mm (L). Mean width was 18.3 ± 0.74 mm (R) and 19.3 ± 0.98 mm (L). The C8 spinal nerve was found on average approximately halfway [16.4 ± 0.74 mm (R) and 15.9 ± 0.95 mm (L)] in the VT. The VA was present in the VT in 100% of the sample and the C7 spinal nerve and inferior sympathetic ganglia were present in more than 80% of the sample.

Conclusion

Understanding the VT and the content is of the utmost importance and of great interest to neurosurgeons, to avoid these important neurovascular structures and prevent iatrogenic complications during surgery.

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Acknowledgements

The authors would like to thank the following individuals: Dr Alfred Musekiwa, senior lecturer in the Health Measurement Sciences division at the University of Pretoria specializing in biostatistics, for his contributions to the data analyses in this study. Ms Helene Biemond for her wonderful drawings and assistance.

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Contributions

SG: protocol development, data collection, data analysis, manuscript writing. LP: project co-supervisor, manuscript editing. NK: project co-supervisor, manuscript editing, data analysis. AvS: project supervisor, project development, manuscript editing.

Corresponding author

Correspondence to Shavana Govender.

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Govender, S., Prigge, L., Keough, N. et al. A quantitative analysis of the dimensions and content of the vertebral triangle. Surg Radiol Anat (2021). https://doi.org/10.1007/s00276-020-02645-x

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Keyword

  • Cervical ganglia
  • Brachial plexus
  • Root of neck
  • Vertebral artery
  • Vertebral triangle