This material is accepted for publication in Operative Neurosurgery journal (click on name to open):
Toma Spiriev, Vladimir Nakov, Jan F Cornelius. Photorealistic 3-Dimensional Models of the Anatomy and Neurosurgical Approaches to the V2, V3, and V4
Toma Spiriev, Vladimir Nakov, Jan F Cornelius. Photorealistic 3-Dimensional Models of the Anatomy and Neurosurgical Approaches to the V2, V3, and V4
3D Model - segments of the vertebral artery.
A far lateral craniotomy is simulated revealing
the V4 segment of the vertebral artery:
the V4 segment of the vertebral artery:
Model. 1 The skin has been reflected and the trapezius, splenius and sternocleidomastoid muscles are presented.
Annotations Trapezius m., Occipital a., Splenius capitis m., Sternocleidomastoid m., Postero-lateral fat pad, Sternocleidomastoid m., Splenius capitis m., External jugular v., Levator scapulae m.
Annotations Trapezius m., Occipital a., Splenius capitis m., Sternocleidomastoid m., Postero-lateral fat pad, Sternocleidomastoid m., Splenius capitis m., External jugular v., Levator scapulae m.
Model. 2 The trapezius m. is mobilised and reflected caudally.
The splenius m. is presented. On the left side the postero-lateral fat pad between has been dissected an the IX nerve is presented.
Annotations Splenius capitis m., Semispinalis capitis m., Occipitalis major n., Occipital a., Levator scapulae m., XI nerve, Sternocleidomastoid m., External jugular vein, Linea nuchae
The splenius m. is presented. On the left side the postero-lateral fat pad between has been dissected an the IX nerve is presented.
Annotations Splenius capitis m., Semispinalis capitis m., Occipitalis major n., Occipital a., Levator scapulae m., XI nerve, Sternocleidomastoid m., External jugular vein, Linea nuchae
Model. 3 Both splenius mm. are mobilized and reflected caudally.
The semispinalis capitis mm., longissimus and and levator scapuale mm. are presented.
The greateroccipital nerve is visibel on the right side.
Annotations Semispinalis capitis m., Linea nuchae, Occipitalis major n., Occipital a., Longissimus capitis m., Levator scapulae m., IX nerve
The semispinalis capitis mm., longissimus and and levator scapuale mm. are presented.
The greateroccipital nerve is visibel on the right side.
Annotations Semispinalis capitis m., Linea nuchae, Occipitalis major n., Occipital a., Longissimus capitis m., Levator scapulae m., IX nerve
Model. 4 The suboccpital triangle (superior and inferior oblique mm. as well as rectus capistis posterior major m.) containig the suboccipital venous plexus and vertebral artery is presented.
Annotations Semispinalis cervicis m., Semispinalis capitis m., C2 spinous process, Rectus capitis posterior minor m., Rectus capitis posterior major m., Superior oblique m., Inferior oblique m., Digastric m., Occipital a., Suboccipital venous plexus
Annotations Semispinalis cervicis m., Semispinalis capitis m., C2 spinous process, Rectus capitis posterior minor m., Rectus capitis posterior major m., Superior oblique m., Inferior oblique m., Digastric m., Occipital a., Suboccipital venous plexus
Model. 5 The muscles of the suboccpital triangle were removed on the left side and the fat pad with the suboccipital venous plexus and the vertebral artery were presented.
Annotations C2 spinous process, Rectus capitis posterior minor m., Suboccipital fat pad, Rectus capitis posterior major m., Inferior oblique m., Superior oblique m., Occipital a., Semispinalis capitis m.
Annotations C2 spinous process, Rectus capitis posterior minor m., Suboccipital fat pad, Rectus capitis posterior major m., Inferior oblique m., Superior oblique m., Occipital a., Semispinalis capitis m.
Model. 6 The vertebral artery is mobilised subperiostely. The suboccpital venous plexus is removed an the V2 and V3 segments of the vertebral artery are presented.
Annotations Semispinalis cervicis m., Sempispinalis capitis m., C2 spinous process, C1 posterior arch, Vertebral artery, Condylar joint, C2 nerve root, C1-C2 joint, Rectus capitis lateralis m., Occipital a., Rectus capitis posterior major m., Superior oblique m., Inferior oblique m., Suboccipital venous plexus
Annotations Semispinalis cervicis m., Sempispinalis capitis m., C2 spinous process, C1 posterior arch, Vertebral artery, Condylar joint, C2 nerve root, C1-C2 joint, Rectus capitis lateralis m., Occipital a., Rectus capitis posterior major m., Superior oblique m., Inferior oblique m., Suboccipital venous plexus
Model. 7 Part of the occipital bone and the mastoid were removed exposing the transverse and sigmoid sinuses.
The postiro fossa dura is exposed.
Annotations Transverse sinus, Sigmoid sinus, Asterion, Mastoid emissary vein, Vertebral artery, C2 nerve root, C1 transverse process, Condylar joint, C1 posterior arch, C2 lamina, External occipital protuberance, Semispinalis cervicis m., Semispinalis capitis m., Occipital a., Facal n., Jugular v., External carotid a.
The postiro fossa dura is exposed.
Annotations Transverse sinus, Sigmoid sinus, Asterion, Mastoid emissary vein, Vertebral artery, C2 nerve root, C1 transverse process, Condylar joint, C1 posterior arch, C2 lamina, External occipital protuberance, Semispinalis cervicis m., Semispinalis capitis m., Occipital a., Facal n., Jugular v., External carotid a.
Model. 8 The occipital condyle was partially removed.
Annotations Occipital condyle, C1 superior articular process, Vertebral artery, Spinal dura, C2 nerve, C1 transverse process, Transverse sinus, Asterion, Sigmoid sinus, Mastoid emissary vein, Vertebral a., Facial n., Occipital a.
Annotations Occipital condyle, C1 superior articular process, Vertebral artery, Spinal dura, C2 nerve, C1 transverse process, Transverse sinus, Asterion, Sigmoid sinus, Mastoid emissary vein, Vertebral a., Facial n., Occipital a.
Model. 9 The dura is opened and the caudal group of cerebellopontine angle nerves is presented (IX, X, XI). The V4 segment of the VA is presented.
Annotations Vertebral a. V3 segment, Vertebral a. V4 segment, Vertebral a. Horizontal portion, Vertebral a. Vertical portion, IX/X nerve group, XI nerve, Sigmoid sinus, Mastoid emissary vein, Transverse sinus, Occipital a., Facial n., Jugular v.
Annotations Vertebral a. V3 segment, Vertebral a. V4 segment, Vertebral a. Horizontal portion, Vertebral a. Vertical portion, IX/X nerve group, XI nerve, Sigmoid sinus, Mastoid emissary vein, Transverse sinus, Occipital a., Facial n., Jugular v.
Model. 10 In neutral position, the vertical and horizontal portions of the V3 segment of the vertebral artery are perpendicular. After the head is rotated to contralateral side and extended (as required by the anterolateral approach) both segments are stretched and run parallel, only separated by the groove of the posterior arch of the atlas.
Annotations Vertebral artery - vertical portion, Vertebral artery - horizontal portion, Vertebral artery - vertical portion (rotated head)
Annotations Vertebral artery - vertical portion, Vertebral artery - horizontal portion, Vertebral artery - vertical portion (rotated head)