The intracranial denticulate ligament

Anatomical study with neurosurgical significance: Laboratory investigation

R. Shane Tubbs, Martin M. Mortazavi, Marios Loukas, Mohammadali Mohajel Shoja, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Object. Knowledge of the detailed anatomy of the craniocervical junction is important to neurosurgeons. To the authors' knowledge, no study has addressed the detailed anatomy of the intracranial (first) denticulate ligament and its intracranial course and relationships. Methods. In 10 embalmed and 5 unembalmed adult cadavers, the authors performed posterior dissection of the craniocervical junction to expose the intracranial denticulate ligament. Rotation of the spinomedullary junction was documented before and after transection of unilateral ligaments. Results. The first denticulate ligament was found on all but one left side and attached to the dura of the marginal sinus superior to the vertebral artery as it pierced the dura mater. The ligament always traveled between the vertebral artery and spinal accessory nerve. On 20% of sides, it also attached to the intracranial vertebral artery and, histologically, blended with its adventitia. In general, this ligament tended to be thicker laterally and was often cribriform in nature medially. The hypoglossal nerve was always superior to the ligament, which always concealed the ventral roots of the C-1 spinal nerve. The posterior spinal artery traveled posterior to this ligament on 93% of sides. On one left side, the ascending branch of the posterior spinal artery traveled anterior to the ligament and the descending branch traveled posterior to it. Following unilateral transection of the intracranial denticulate ligament, rotation of the spinomedullary junction was increased by approximately 25%. Conclusions. Knowledge of the relationships of the first denticulate ligament may prove useful to the neurosurgeon during procedures at the craniocervical junction.

Original languageEnglish (US)
Pages (from-to)454-457
Number of pages4
JournalJournal of Neurosurgery
Volume114
Issue number2
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Ligaments
Vertebral Artery
Anatomy
Arteries
Accessory Nerve
Hypoglossal Nerve
Dura Mater
Spinal Nerves
Adventitia
Spinal Nerve Roots
Cadaver
Dissection

Keywords

  • Anatomy
  • Craniocervical junction
  • Dentate ligament
  • Foramen magnum
  • Neurosurgery
  • Vertebral artery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

The intracranial denticulate ligament : Anatomical study with neurosurgical significance: Laboratory investigation. / Tubbs, R. Shane; Mortazavi, Martin M.; Loukas, Marios; Mohajel Shoja, Mohammadali; Cohen-Gadol, Aaron A.

In: Journal of Neurosurgery, Vol. 114, No. 2, 01.02.2011, p. 454-457.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Mortazavi, Martin M. ; Loukas, Marios ; Mohajel Shoja, Mohammadali ; Cohen-Gadol, Aaron A. / The intracranial denticulate ligament : Anatomical study with neurosurgical significance: Laboratory investigation. In: Journal of Neurosurgery. 2011 ; Vol. 114, No. 2. pp. 454-457.
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abstract = "Object. Knowledge of the detailed anatomy of the craniocervical junction is important to neurosurgeons. To the authors' knowledge, no study has addressed the detailed anatomy of the intracranial (first) denticulate ligament and its intracranial course and relationships. Methods. In 10 embalmed and 5 unembalmed adult cadavers, the authors performed posterior dissection of the craniocervical junction to expose the intracranial denticulate ligament. Rotation of the spinomedullary junction was documented before and after transection of unilateral ligaments. Results. The first denticulate ligament was found on all but one left side and attached to the dura of the marginal sinus superior to the vertebral artery as it pierced the dura mater. The ligament always traveled between the vertebral artery and spinal accessory nerve. On 20{\%} of sides, it also attached to the intracranial vertebral artery and, histologically, blended with its adventitia. In general, this ligament tended to be thicker laterally and was often cribriform in nature medially. The hypoglossal nerve was always superior to the ligament, which always concealed the ventral roots of the C-1 spinal nerve. The posterior spinal artery traveled posterior to this ligament on 93{\%} of sides. On one left side, the ascending branch of the posterior spinal artery traveled anterior to the ligament and the descending branch traveled posterior to it. Following unilateral transection of the intracranial denticulate ligament, rotation of the spinomedullary junction was increased by approximately 25{\%}. Conclusions. Knowledge of the relationships of the first denticulate ligament may prove useful to the neurosurgeon during procedures at the craniocervical junction.",
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