The fine connective tissue architecture of the human ligamentum nuchae

Study Design. An anatomic study of the posterior midline structures of the cervical spine was performed using anew sheet-plastination (E12) technique in conjunction with gross anatomic dissection. Objectives. To clarify the structural status of the human ligamentum nuchae. Summary of Background Data. Little is known about the arrangement of connective tissue attachments of the neighboring neck muscles to the ligamentum nuchae. In addition, it is not clear whether the cervical supraspinous ligaments form part of the ligamentum nuchae. Methods. This study used a combined approach of a detailed gross anatomic study on eight cadavers and a macroscopic and microscopic study of the connective tissue organization of the posterior midline structures on;serial horizontal thin (2.5 mm) plastinated slices of the cervical spine (occiput-T1) from an adult female cadaver. Results. The dorsal and ventral portions of the ligamentum nuchae are a single entity formed by the aponeurotic fibers of the trapezius, splenius capitis, rhomboideus minor, and serratus posterior superior muscles. Conclusions. The regional differences in the connective tissue organization of the ligamentum nuchae and its well-defined attachments to the C6 and C7 vertebrae suggest that it is designed to function in the lower cervical spine.