The Neural Sulcus of the Cervical Vertebrae: A Review of Its Anatomy and Surgical Perspectives

The neural sulcus is a bony channel that spans the transverse process in the subaxial cervical spine. It is located between the anterior and posterior tubercles on either side of the transverse foramen, housing the spinal nerve as it passes through the intervertebral foramina. Although numerous studies have evaluated the anatomy of the cervical spine, very little data on detailed anatomy of the neural sulcus and its implication in cervical spine surgery exist. Here, we review the anatomy of the neural sulcus and surgical considerations. The neural sulcus has important surgical implications, and knowledge of its anatomy is important in considering and planning posterior cervical segmented instrumentation. This increases the ability of the neurosurgeon to choose the best suitable surgical approach to the subaxial cervical spine, allowing good outcomes for the patient.