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open access eISSN 2093-3673

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Original Article

Anat Cell Biol 2024; 57(3): 378-383

Published online September 30, 2024

https://doi.org/10.5115/acb.24.061

Copyright © Korean Association of ANATOMISTS.

Variability in the projection level of the vertebra prominens: a cadaveric study

Trifon Totlis1 , Andreas Sammer2,3 , Maria Piagkou4 , Konstantinos Natsis1 , Panagiotis-Konstantinos Emfietzis1 , Filippos Karageorgos1 , George Tsakotos4 , George Triantafyllou4 , Georg Feigl5,6

1Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece, 2Österreichische Arbeitsgemeinschaft für Manuelle Medizin, Graz, 3Ordination Dr. Sammer, Raaba/Grambach, Austria, 4Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece, 5Institute for Anatomy and Clinical Morphology, Witten/Herdecke University, Witten, Germany, 6Institute of Clinical Morphology, Medical University of Graz, Graz, Austria

Correspondence to:Trifon Totlis
Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
E-mail: totlis@auth.gr

Received: March 2, 2024; Revised: April 23, 2024; Accepted: April 29, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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: Spine, Anatomy, Vertebra, Cadaver, Palpation

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