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Title: The arterial supply of the cervical and thoracic spinal muscles and overlying skin: Anatomical study with implications for surgical wound complications.
Epworth Authors: Richardson, Martin
De La Harpe, David
Other Authors: Yue, Brian
le Roux, Cara
Corlett, Russell
Ashton, Mark
Keywords: Postoperative Spinal Wound Dehiscence
Surgical Wound Dehiscence
Paraspinal Muscles
Spinal Vasculature
Intercostal Muscles
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Department of Surgery, Epworth Hospital, Melbourne, Victoria, Australia
Issue Date: Jul-2013
Publisher: Wiley Online Library
Citation: Clinical Anatomy. 2013 Jul;26(5):584-91.
Abstract: Postoperative spinal wound dehiscence is a significant complication following the posterior midline approach. It is postulated that this approach disrupts the vasculature supplying the paraspinal muscles and overlying skin. Although the spinal vasculature has been investigated previously, the smaller arterioles have not been described in the context of the posterior midline approach. Eight cadaveric neck and posterior torso specimens were dissected after injection with a radio-opaque lead oxide mixture and subsequent radiographs taken were analyzed. The deep cervical, vertebral, superficial cervical, and occipital arteries consistently supplied the cervical paraspinal muscles. The latter two arteries also vascularized the overlying skin. The deep cervical arteries were found to be located lateral to the C3 to C6 vertebrae, vulnerable to damage with the posterior approach. In the thoracic region, the superior and posterior intercostal arteries consistently supplied the spinal muscles. In all specimens, two small anastomotic vessels posterior to the laminae were found connecting the intercostal artery perforators. Both the arterial perforators and their anastomotic channels were situated in the surgical field and susceptible to damage with the posterior approach. It is likely that the disruption in spinal vasculature contributes to the multifactorial problem of wound dehiscence with the posterior midline approach.
DOI: 10.1002/ca.22139
PubMed URL:
ISSN: 1098-2353
Journal Title: Clinical Anatomy
Type: Journal Article
Affiliated Organisations: Taylor Lab, Department of Anatomy and Neuroscience, University of Melbourne, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Musculoskeletal

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