Clinical Anatomy of the Extradural Neural Axis Compartment: A Literature Review

Objective The extradural neural axis compartment (EDNAC) is an adipovenous zone located between the meningeal and endosteal layers of the dura and has been minimally investigated. It runs along the neuraxis from the orbits down to the coccyx and contains fat, valveless veins, arteries, and nerves. In the present review, we have outlined the current knowledge regarding the structural and functional significance of the EDNAC. Methods We performed a narrative review of the reported EDNAC data. Results The EDNAC can be organized into 4 regional enlargements along its length: the orbital, lateral sellar, clival, and spinal segments, with a lateral sellar orbital junction linking the orbital and lateral sellar segments. The orbital EDNAC facilitates the movement of the eyeball and elsewhere allows limited motility for the meningeal dura. The major nerves and vessels are cushioned and supported by the EDNAC. Increased intra-abdominal pressure will also be conveyed along the spinal EDNAC, causing increased venous pressure in the spine and cranium. From a pathological perspective, the EDNAC functions as a low-resistance, extradural passageway that might facilitate tumor encroachment and expansion. Conclusions Clinicians should be aware of the extent and significance of the EDNAC, which could affect skull base and spine surgery, and have an understanding of the tumor spread pathways and growth patterns. Comparatively little research has focused on the EDNAC since its initial description. Therefore, future investigations are required to provide more information on this underappreciated component of neuraxial anatomy.

• Tipo de recurso: Article of journal
• Fecha de publicación: 2020
• Institución: Universidad de Bogotá Jorge Tadeo Lozano
• Repositorio: Expeditio: repositorio UTadeo
• Idioma: eng
• OAI Identifier: oai:expeditiorepositorio.utadeo.edu.co:20.500.12010/12265
• Acceso en línea: https://www.sciencedirect.com/science/article/pii/S1878875020316168?via%3Dihub; http://hdl.handle.net/20.500.12010/12265; https://doi.org/10.1016/j.wneu.2020.07.095
• Palabra clave: COVID-19; Síndrome respiratorio agudo grave; COVID-19; SARS-CoV-2; Coronavirus; Cavernous sinus; Extradural neural axis compartment; Intervertebral foramen; Lateral sellar compartment; Orbit; Spinal epidural space; Tumor growth
• License: Acceso restringido