title: Anatomic study and clinical significance of the dorsal meningovertebral ligaments of the thoracic dura mater.
abstract: METHODS
  A dissection-based study of 18 embalmed thoracic specimens.
  
  
  OBJECTIVE
  To investigate the properties and clinical significance of the dorsal meningovertebral ligaments of the thoracic dura mater.
  
  
  BACKGROUND
  Previously, we performed a comprehensive anatomic study on the dorsal meningovertebral ligaments in the lumbosacral and cervical regions, whereby we concluded that the ligaments were an anatomic factor leading to dural laceration and hemorrhage during flavectomy and laminectomy. Unfortunately, thus far, no systematic anatomic study has been undertaken to examine the dorsal meningovertebral ligaments of the thoracic dura mater.
  
  
  METHODS
  Eighteen adult embalmed cadavers were studied, and the morphology, orientation, attachment site, and distribution traits of the dorsal meningovertebal ligaments were observed. In addition, the length, width, or diameter and thickness of the ligaments were measured using a Vernier caliper. Two meningovertebal ligaments were removed for histological examination.
  
  
  RESULTS
  In the thoracic region, the dorsal meningovertebral ligaments anchored the dura mater to the lamina or ligamentum flavum. The meningovertebral ligaments displayed a relatively even distribution along the upper thoracic region (T1-T7) and a gradual increase in frequency in the lower thoracic region from T7 to T12. The meningovertebral ligaments protrude into the dura and correspondingly become an integral part of the dura. Some ligaments are accompanied by or are attached to blood vessels. Histological examination of the meningovertebral ligaments revealed fibrous connective tissue.
  
  
  CONCLUSIONS
  The dorsal meningovertebral ligaments exist between the dural sac and ligamentum flavum or lamina in the thoracic spine. Based on their anatomic features, meningovertebral ligaments may be one potential cause for dural laceration and epidural hemorrhage. We propose that, during thoracic flavectomy and laminectomy, the meningovertebral ligaments should first be identified and properly handled, thereby minimizing the occurrence of relevant complications.
  
  
  METHODS
  N/A.
authors.affiliation: *Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China †Department of Orthopedics, The 180th Hospital of People's Liberation Army, Fujian, China ‡Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangdong, China.
authors.forename: Rongzi
authors.initials: R
authors.lastname: Chen
authors.forename: Benchao
authors.initials: B
authors.lastname: Shi
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zheng
authors.forename: Zhilai
authors.initials: Z
authors.lastname: Zhou
authors.forename: Anmin
authors.initials: A
authors.lastname: Jin
authors.forename: Zihai
authors.initials: Z
authors.lastname: Ding
authors.forename: Hai
authors.initials: H
authors.lastname: Lv
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D002102:Cadaver; D004210:Dissection; D004388:Dura Mater / Q000033:anatomy & histology* / Q000601:surgery; D005260:Female; D006801:Humans; D017843:Ligamentum Flavum / Q000033:anatomy & histology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D066148:Spinal Cord Dorsal Horn / Q000033:anatomy & histology; D013904:Thoracic Vertebrae / Q000033:anatomy & histology* / Q000601:surgery