The ligaments and annulus fibrosus of human adult cervical intervertebral discs.

STUDY DESIGN: Descriptive, microdissection study.

OBJECTIVE: To determine the morphology of the human adult cervical intervertebral disc and its ligaments.

SUMMARY OF BACKGROUND DATA: Some studies indicate that the cervical disc is distinctly different from the lumbar intervertebral disc, yet most clinical and anatomic texts appear content with extrapolating data from the lumbar spine. A detailed three-dimensional description of the cervical intervertebral disc and its surrounding ligaments is currently unavailable.

METHODS: Whole cervical spinal columns were freed from 12 human adult embalmed cadavers, and the posterior elements and soft tissues were removed. Using microdissection, the longitudinal ligaments and the fibrous components of 59 cervical intervertebral disc were resected systematically. The orientation, location, and attachments of each stripped bundle of collagen were recorded photographically and in sketches.

RESULTS: The cervical anulus fibrosus does not consist of concentric laminae of collagen fibers as in lumbar discs. Instead, it forms a crescentic mass of collagen thick anteriorly and tapering laterally toward the uncinate processes. It is essentially deficient posterolaterally and is represented posteriorly only by a thin layer of paramedian, vertically orientated fibers. The anterior longitudinal ligament covers the front of the disc, and the posterior longitudinal ligament reinforces the deficient posterior anulus fibrosus with longitudinal and alar fibers.

CONCLUSIONS: The three-dimensional architecture of the cervical anulus fibrosus is more like a crescentic anterior interosseous ligament than a ring of fibers surrounding the nucleus pulposus.