Abstract:

Objective　To make the anterior cervical approach more reasonable and safer by means of investigating the anatomic features of the prevertebral fascia and its anatomic relationships to surrounding organs.　Methods　Twenty-two embalmed cadavers were dissected. At the level of cricoid cartilage the trachea and esophagus were divided and pulled aside to observe the lateral transition and continuation of the prevertebral fascia and observe the location and corresponding level to the cervical vertebra where the inferior thyroid artery and the right recurrent laryngeal nerve exit from the prevertebral fascia and its location relationship to the carotid sheath. At the same level the carotid sheath and its content and the prevertebral fascia were cut transversely to observe the layers and texture of the prevertebral fascia and transition of each layer , the morphology of the carotid sheath and its relationship to each layer of the prevertebral fascia were observed.  The degree of difficulty of dissecting the superficial layer of prevertebral fascia from the deep layer and dissecting the deep layer prevertebral fascia from the anterior cervical vertebral body was assessed.　Results　The prevertebral fascia was composed of the superficial layer and deep layer, the former was thick and dense, forming the anterior and posterior part of carotid sheath., and the former can be dissected from the latter easily. The right recurrent laryngeal nerve exit from the prevertebral fascia at approximately the leval of T1 vertebrae at the medial margin of the carotid sheath, and the inferior thyroid artery exit from the prevertebral fascia at approximately the leval of C6 vertebrae at the medial margin of the carotid sheath.   Conclusions　The anatomic features of the prevertebral fascia can be utilized to make the anterior cervical approach more reasonable and safer.

Key words: Cervical fascia, Carotid sheath, Cervical spondylosis, Anatomy