Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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Variability in the projection level of the vertebra prominens: a cadaveric study

  • Trifon Totlis (Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Andreas Sammer (Osterreichische Arbeitsgemeinschaft fur Manuelle Medizin) ;
  • Maria Piagkou (Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens) ;
  • Konstantinos Natsis (Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Panagiotis-Konstantinos Emfietzis (Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Filippos Karageorgos (Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • George Tsakotos (Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens) ;
  • George Triantafyllou (Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens) ;
  • Georg Feigl (Institute for Anatomy and Clinical Morphology, Witten/Herdecke University)
  • Received : 2024.03.02
  • Accepted : 2024.04.29
  • Published : 2024.09.30
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Abstract

The 7th cervical vertebra (C7) is described as having the most prominent spinous process (SP) and is characterized as the "vertebra prominens" (VP) of the cervical spine in anatomy textbooks. The VP is an important anatomical landmark of the neck for clinical examination and therapeutic intervention. The present study identifies the level of the most prominent SP of the cervical and uppermost thoracic vertebrae in a cadaveric cohort. Thirty-nine (23 female and 16 male) cadavers of a mean age of 77.5 years were investigated in a prone position and a certain cervical kyphotic bending. The most prominent SP, at the base of the neck, was palpated and marked with a wedging nail into the SP of the vertebra. The cervical region was dissected, and a blind investigator examined whether the nail was placed into the SP of C7 or the SP of another upper or lower vertebra. In 19 out of 39 cadavers (48.7%), the C7 was identified as the VP (typical anatomy), followed by the C6 (in 14 cadavers, 35.9%), C5 (in 4 cadavers, 10.3%). In 2 cadavers (5.1%) the first thoracic vertebra was identified as having the most prominent SP. Although C7 is described as the VP, in the present study the SP of C7 was the most prominent in less than 50%. The high variable projection level of the most prominent SP of the cervical vertebra holds great clinical significance for spine examination, neck surgery, and spinal anesthesia.

Keywords

Acknowledgement

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge which can then improve patient care. Therefore, these donors and their families deserve our highest gratitude.

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