Prevertebral space is a space in the neck region defined by the anterior part of the cervical spine and the deep layer of the deep cervical fascia running between the transverse processes of the spine.
The prevertebral space extends from the skull base into the mediastinum and ends at the level of the fourth thoracic vertebra.
The prevertebral space contains
- The prevertebral muscles (longus colli and longus capitis)
- Vertebral vessels
- Scalene muscles
- Phrenic nerve
- proximal part of the brachial plexus.
On lateral cervical spine xray, the normal prevertebral space looks like this.
Normal dimension in adult are 4 mm at C3 level. Greater than 7 mm value are definitely abnormal and cause should be looked for.
If the values lie in between, a clinical correlation must be sought.
Prevertebral space may get enlarged due to pathology of cervical spine that leads to accumulation of fluid, blood or pus in the space.
Prevertebral space is evaluated on the lateral view of cervical spine as seen above. It is one of the important compnent of cervical spine xray evaluation.
Many a times, enlargement of prevertebral space is the finding that raises the doubt about pathology. Infections particularly tuberculosis may otherwise not produce much symptoms and suspicion may be raised from examination of prevertebral space.
Hematome accumulatio in prevertebral space can lead to its enlargement following an injury to the neck. Tumors and metastases may spread to this space to cause enlargement.
The conditions that lead to enlargement of prevertebral space and consequent increase of its width in xray are following –
- Trauma of cervical spine
- Vertebral osteomyelitis
- Vertebral metastasis.
- Hodgkin lymphoma
- Posterior spread of squamous cell carcinoma head and neck
- Primary tumours arising from tissues belonging to this space.
If the prevertebral space is increased a computed tomogram or MRI should be done for further evaluation of pathology.
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