Dextrocardia and Situs Inversus with Incomplete Inversion: a Case Report / 체질인류학회지

Situs inversus totalis is a very rare anatomical abnormality, which is characterized by dextrocardia and "mirror image" distribution of abdominal organs. Dextrocardia and situs inversus have important surgical implications due to altered anatomy. The aim of this study was to describe the anatomical structures of the situs inversus with dextrocardia in Korean. Presence of situs inversus with dextrocardia was confirmed in a 72-year-old female cadaver during dissection in a gross anatomy course. It was observed by focusing on the positions of the thoracoabdominal structures. In this cadaver, clearly inverted morpholoiges existed in the structures of the thoracoabdomen except the kidneys. The left-sided kidney was located at a slightly higher level than the right-sided kidney although the liver was located on the left side. We reported herein a case of dextrocardia and situs inversus with incomplete inversion, which will provide useful information for accurate diagnosis and relevant surgical procedures.

Anatomical Studies of the Upper and Lower Subscapular Nerves / 체질인류학회지

This study aimed to determine the number of branches of the upper and lower subscapular nerves and to classify the spinal nerve compositions of each branch. Twenty sides of the brachial plexus extracted from Korean adult cadavers were used in this study. The upper subscapular nerve was composed of three branches in 16 sides (80.0%), composed of four branches in 4 sides (20.0%). The lower subscapular nerve arose from posterior cord with one branch, innervating the subscapularis and the teres major muscles. In case of the upper subscapular nerve, the first branch was comprised of C5 in 40.0%, C5 and C6 in 60.0%, the second branch was composed of C5 in 15.0%, C5 and C6 in 85.0%, the third branch was arisen from C5 and C6 in 75.0%, C6 in 25.0% and the forth branch appeared in four sided was derived from C6. The nerve branch innervating the subscapularis muscle was composed of C6 in 55.0%, C5 and C6 in 40.0%, C6 and C7 in 5.0%. The nerve branch innervating the teres major muscle was composed of C6 and C7 in 65.0%, C5, C6 and C7 in 25.0%, and C6 in 10.0%. The injury was often due to an accidental damage or lesion of the subscapular nerve, these anatomical results may be helpful to predict the involving area of the lesion.

Expression of transient receptor potential channels in the ependymal cells of the developing rat brain / 대한해부학회지

Cerebrospinal fluid (CSF) plays an important role in providing brain tissue with a stable internal environment as well as in absorbing mechanical and thermal stresses. From its initial composition, derived from the amniotic fluid trapped by the closure of neuropores, CSF is modified by developing and differentiating ependymal cells lining the ventricular surface or forming the choroid plexus. Its osmolarity and ionic composition brings about a change through the action of many channels expressed on the ependymal cells. Some newly discovered transient receptor potential (TRP) channels are known to be expressed in the choroid plexus ependyma. To detect additional TRP channel expression, immunohistochemical screening was performed at the choroid plexus of 13-, 15-, 17-, and 19-day embryos, using antibodies against TRPV1, TRPV3, and TRPA1, and the expression was compared with those in the adult TRP channels. The level of TRP channel expression was higher in the choroid plexus which suggests more active functioning of TRP channels in the developing choroid plexus than the ventricular lining ependyma in the 15- and 17-day embryos. All the expression of TRP channels decreased at the 19th day of gestation. TRPA1 was expressed at a higher level than TRPV1 and TRPV3 in almost all stages in both the choroid plexus and ventricular lining epithelium. The highest level of TRPV1 and TRPV3 expression was observed in association with the glycogen deposits in the cytoplasm of the choroid plexus ependymal cells of the 15- and 17-day embryos.

Frequency and Quantity of the C7 Contribution to the Ulnar Nerve / 체질인류학회지

Many anatomists and clinicians who investigate the peripheral nerve concern about the composition of the spinal roots of each terminal nerve of the brachial plexus. From this viewpoint, the spinal root composition of the ulnar nerve is still unclear. Several anatomy textbooks describe that the ulnar nerve is composed of the ventral rami of the C8, T1 and often C7. There is no literature regarding the frequency and contribution quantity of C7 to the ulnar nerve. The purpose of present study was to determine frequency and contribution quantity of the C7 to the ulnar nerve. Fifty cadavers of brachial plexus were obtained from cadavers of Korean adults. The brachial plexus containing the ulnar nerve were extracted from the axilla and the extracted samples were immersed in Guanidine-HCl (0.2 M) for 2 weeks to soften the connective tissue around the nerve bundles. C7 was contributed to the ulnar nerve in all sides (100%). The numbers of the myelinated axons of C7 participating to the ulnar nerve was 1,452+/-429 (mean+/-S.D.). Thus the C7 can be considered as always participating component of the ulnar nerve, not often participation, although numbers of the myelinated axons of C7 was lesser than those of the C8, but similar to those of the T1. The results of the study provide a reference for accurate diagnosis and treatment regarding ulnar nerve injury due to various accidents.

An Unusual Communication between the Radial and the Ulnar Nerves / 체질인류학회지

This case report describes an unusual communicating branch from radial to ulnar nerves in the axilla region on the right side of the Korean cadaver of a 59-year-old male. The brachial plexus containing the communicating branch were extracted en bloc. The extracted specimens were immersed in Guanidine-HCl (0.2 M) for two weeks and then treated several times with an ultrasonic cleaner for an hour to soften the connective tissue around the nerve bundles. The spinal root origins of this communicating branch were found to be largely C7 and some C8. Unexpectedly, the branches of the ulnar nerve innervated the medial two-third of the medial head of the triceps brachii muscle on the right side in the same cadaver. Numbers of nerve fibers of the communicating branch and the main distributing branch of the ulnar nerve to the triceps brachii muscle were 523 and 525, respectively. This result implies that nerve fibers moving from the radial to the ulnar nerves may innervate the original distributing territories of the radial nerve. Another possibility is that a part of radial muscular branch to the triceps beachii muscle may be fused to the ulnar nerve in their distributing territories.

Unusual Course of the Accessory Meningeal Artery / 체질인류학회지

This case report describes a variation in the course of the accessory meningeal artery relative to the mandibular nerve in the infratemporal fossa. An accessory meningeal artery running superficially to the posterior division of mandibular nerve was found bilaterally in the cadaver of a 95-year-old male. It was observed by a topographic examination followed by a detailed dissection. The accessory meningeal artery arose from the middle meningeal artery. It then passed upward and coursed superficial to the posterior division of the mandibular nerve before its division into the lingual and inferior alveolar nerves. The accessory meningeal artery subsequently ran deep and rostral to the anterior and posterior divisions of the mandibular nerve, respectively, before entering the foramen ovale. The variation in the course of the accessory meningeal artery described herein should be helpful for surgeons in approaches to the foramen ovale region and infratemporal fossa.

An Anatomic Variation of the Accessory Abductor Digiti Minimi Muscle / 체질인류학회지

Accessory muscles passing through Guyon's canal are common; the most common anomalous muscle at Guyon's canal is the accessory abductor digiti minimi muscle (AADM). The aim of this study was to demonstrate and describe the gross anatomy of an anatomic variant of the AADM relative to the surrounding structures. The AADM was found in the left forearm and hand of a 61-year-old male cadaver during dissection in a gross anatomy course. It was observed by focusing on the shape, the course, and its relationship with the surrounding structures. The AADM originated as muscle fibers from the antebrachial fascia. It coursed downward in the distal forearm and crossed the ulnar nerve and artery obliquely at Guyon's canal. The AADM narrowed and became a long tendon in the hypothenar region. The abductor digiti minimi muscle was partly attached to the tendon of the AADM, running along the tendon. The tendon of the AADM inserted into the ulnar side of head of the fifth metacarpal bone. The AADM was innervated by several twigs from the ulnar nerve. We reported herein another variant of the AADM at Guyon's canal, which may be helpful to surgeons performing diagnoses and surgical procedures.

Anatomic Confirmation of the Motor Fibers in the Cervical Nerves Innervating to the Trapezius Muscle / 체질인류학회지

This study aimed to confirm the presence of motor fibers in the cervical nerves distributing to the trapezius muscle. Thirteen cases were examined. Motor fibers were present in C3 in 7 of 9 cases (77.8%) and were absent in 2 of 9 cases (22.3%); the other 4 cases were damaged during dissection. C4 exhibited motor fibers in 9 of 10 cases (90.0%), whereas motor fibers were absent in 1 of 10 cases (10.0%); and 3 cases were damaged. The motor fibers in C3 were of medium size (57.1%; 4/7 cases), whereas those in C4 were large (44.4%; 4/9 cases). The average number of motor fibers in C3 and C4 were 114+/-112 and 219+/-167, respectively. These results show that C4 is more important in terms of the frequency and size of the cervical motor fibers distributing to the trapezius muscle.

Anatomic Confirmation of the Motor Fibers in the Cervical Nerves Innervating to the Trapezius Muscle / 체질인류학회지

This study aimed to confirm the presence of motor fibers in the cervical nerves distributing to the trapezius muscle. Thirteen cases were examined. Motor fibers were present in C3 in 7 of 9 cases (77.8%) and were absent in 2 of 9 cases (22.3%); the other 4 cases were damaged during dissection. C4 exhibited motor fibers in 9 of 10 cases (90.0%), whereas motor fibers were absent in 1 of 10 cases (10.0%); and 3 cases were damaged. The motor fibers in C3 were of medium size (57.1%; 4/7 cases), whereas those in C4 were large (44.4%; 4/9 cases). The average number of motor fibers in C3 and C4 were 114+/-112 and 219+/-167, respectively. These results show that C4 is more important in terms of the frequency and size of the cervical motor fibers distributing to the trapezius muscle.

Spinal Nerve Compositions of the Terminal Branches of the Lumbosacral Plexus / 체질인류학회지

The purpose of this study was to classify the spinal nerve compositions of the terminal branches of the lumbosacral plexus, providing data of their participating quantities. Twenty-five sides of the lumbosacral plexus extracted from Korean adult cadavers were used in this study. The iliohypogastric nerve was mostly arisen from L1 (88.2%, thickness L1 0.7 mm). The ilioinguinal nerve was arisen from only L1 (100%, thickness L1 0.6 mm). The genitofemoral nerve was commonly arisen from L1 and L2 (62.5%, thickness L1 0.6 mm, L2 0.7 mm). The lateral femoral cutaneous nerve was classified into 4 types, and the most common type was that L2 and L3 composed this nerve (56.0%, thickness L2 0.8 mm, L3 0.4 mm). The femoral nerve was classified into 2 types, and it was usually composed of L2, L3 and L4 (88.0%, thickness L2 1.4 mm, L3 2.7 mm, L4 2.3 mm). The obturator nerve was arisen from L2, L3 and L4 in all cases (100%, thickness L2 0.5 mm, L3 1.3 mm, L4 1.1 mm). The common fibular component of sciatic nerve was mostly arisen from L4, L5, S1 and S2 (84.0%, thickness L4 0.9 mm, L5 2.0 mm, S1 2.1 mm, S2 1.2 mm). The tibial component of sciatic nerve was mainly arisen from L4, L5, S1 and S2 (96.0%, thickness L4 0.9 mm, L5 1.9 mm, S1 2.2 mm, S2 1.9 mm). The superior gluteal nerve was commonly derived from L4, L5 and S1 (56.0%, thickness L4 0.7 mm, L5 1.1 mm, S1 0.9 mm). The inferior gluteal nerve was comprised of L5, S1 and S2 in several cases (54.2%, thickness L5 0.9 mm, S1 1.3 mm, S2 0.8 mm). The posterior femoral cutaneous nerve was composed of S1 and S2 in higher freqeuncy (40.0%, thickness S1 0.9 mm, S2 1.0 mm, S3 0.8 mm). The perforating cutaneous nerve was arisen from S2 and S3 in higher frequency (56.0%, thickness S1 0.7 mm, S2 0.9 mm, S3 1.1 mm). The pudendal nerve was derived from S3 in many cases (52.9%, thickness S3 1.5 mm). These anatomical results may be helpful to predict the spinal nerve root lesions of the lumbosacral plexus.

Quantification of the Nerve Fiber of the Terminal Branches of the Typical Brachial Plexus / 체질인류학회지

This study was carried out to evaluate the quantity of the nerve fiber of the terminal branches of the typical brachial plexus in the 6 sides of the Korean adults. The dorsal scapular nerve, which is derived from ramus of the brachial plexus, was comprised of C5 and participating nerve fiber was 355+/-180. The long thoracic nerve was composed of C5, C6 and C7, and was mainly originated from C6, and participating nerve fiber was 743+/-346. The nerves, which are branched out from trunk, nerve to subclavius muscle was composed of C5 and participating quantity was 242+/-71. The suprascapular nerve was comprised of C5 and C6, and the nerve fiber was mainly derived from C5 (1,942+/-505). The nerve, which is originated from proximal portion of the cord, the lateral pectoral nerve was constituted of C5, C6 and C7. The main component was C7 as the 2,917+/-785 nerve fiber. The medial pectoral nerve was made with C8 and T1. The main component was C8 as the 964+/-430 nerve fiber. The upper subscapular nerve was derived from C5 and C6. The nerve fiber was 1,179+/-92 in C5, mainly participated. The Lower subscapular nerve was constituted of C5, C6 and C7. C6 was the main component and contributing nerve fiber was 1,070+/-390 in C6, principal component. The thoracodorsal nerve was formed by C6, C7 and C8. The chief component was C7, contributed of 2,335+/-324. The nerves, which are came out from the distal portion of the cord, musculocutaneous nerve was derived from the C5, C6 and C7. The C6 was principal component, and was joined with 4,009+/-1,883. The median nerve was contributed from C5 to T1. The chief component was C7 added with 9,651+/-2,663. The ulnar nerve was composed of C7, C8 and T1. The C8 was the main component comprised of 10,075+/-1,473. The medial brachial and antebrachial cutaneous nerves was constituted of C8 and T1. In the both nerves, the main component was T1 participated with 1,752+/-390, 3,080+/-1,140 respectively. The radial nerve was composed of C5 to T1. The C7 was principal component added with 7,958+/-2,333. The axillary nerve was made up C5 and C6. In the nerve, the both spinal segments were similarly participated to the nerve. This results could be applied for the injuries and neurotization procedure of the terminal nerves of the brachial plexus.

Masticator space abscess in a 47-day-old infant / 소아과

A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about 2.0x1.5 cm that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

Anatomy of the Blood Supply of Dorsal Side of Thumb and First Web / 체질인류학회지

Distal thumb injuries are a common and difficult problem for hand surgeons. Coverage of soft tissue on the fingers may be difficult due to the size of the defect or the limitation of local flap mobilization. However, the variable anatomy of the dorsal hand vascular system sometimes prevents successful flap harvest. The purpose of this study was to clarify the vascular anatomy of the dorsal side of the thumb and the first web for the flaps. Twenty six hands (13 right and 13 left hands) from Korean embalmed cadavers were dissected. A catheter was inserted into the radial artery in the forearm, and the red colored latex (Latex 671, Dupont Industry, France) was injected until the dorsum of the hand was colored. The arrangement of the first dorsal metacarpal artery (FDMA) and its branches were vary and classified into three categories according to their branching patterns; Both dorso-ulnar thumb branch (DUTB) and dorso-radial index branch (DRIB) arose from the FDMA (10 cases, 38.5%). Each DUTB and DRIB arose separately from the radial artery (5 cases, 19.2%). The DUTB and the DRIB originated from the princeps pollicis artery and the radial artery, respectively (11 cases, 42.3%). The typical course of the FDMA and its branches ran overlying the first dorsal interosseous muscle in 17 cases of the 26 specimens (65.4%). However, in nine cases (34.6%) the DRIB ran on the first dorsal interosseous muscle and the DUTB had a deep course within the substance of the first dorsal interosseous muscle. The FDMA flap represents a good option to cover defects for the thumb. These anatomical findings in the present study could provide useful knowledge of flaps for dorsal aspect of the thumb and the first web.

Median Nerve Branch Innervating the Brachialis Muscle: A Case Report / 체질인류학회지

We observed a slender nerve branch of the lateral root of the median nerve innervating the brachialis muscle, which is normally innervated by the musculocutaneous nerve, at the left arm of a Korean male (age, 74 years). The present nerve branch was accompanied with the communicating branch between the median and musculocutaneous nerves and supplied to the medial inferior portion of the brachialis muscle. The spinal root origins of this branch were C5 and C6. The nerve fiber number of the nerve branch innervating the brachialis muscle was 328. This variation may be very rare case and was different from previous observation.

Variation of the Infrahyoid Muscle: Duplicated Omohyoid and Appearance of the Levator Glandulae Thyroideae Muscles

The embryologic origin of the omohyoid muscle is different from that of the other neck muscles. A number of variations such as the absence of muscle, variable sites of origin and insertion, and multiple bellies have been reported. However, variations in the inferior belly of the omohyoid muscle are rare. There have been no reports of the combined occurrence of the omohyoid muscle variation with the appearance of the levator glandulase thyroideae muscle. Routine dissection of a 51-year-old female cadaver revealed a duplicated omohyoid muscle and the appearance of the levator glandulae thyroideae muscle. In this case, the two inferior bellies of the omohyoid muscle were found to originate inferiorly from the superior border of the scapula. One of the inferior bellies generally continued to the superior belly with the tendinous intersection. The other inferior belly continued into the sternohyoid muscle without the tendinous intersection. In this case, the levator glandulae thyroideae muscle appeared on the left side, which attached from the upper border of the thyroid gland to the inferior border of the thyroid cartilage. These variations are significant for clinicians during endoscopic diagnosis and surgery because of the arterial and nervous damage due to iatrogenic injuries. The embryologic origins of the omohyoid and levator glandulae thyroideae muscles may be similar based on the descriptions in the relevant literature.

Study of the Inferior Epigastric Artery Using Anatomical and Radiologic Method for Flap Surgery / 대한해부학회지

The knowledge of arterial patterns of donor and recipient sites is very important for performing a flap surgery. In order to perform a flap surgery using the rectus abdominis muscle knowledge of the distributions, tributaries, and anastomoses of the inferior epigastric artery is necessary. The aim of this study was to establish the clinical and anatomical characteristics of the inferior epigastric artery for flap surgery in Koreans. Sixteen fresh cadavers were injected bilaterally with a radiopaque dye solution through the brachial and popliteal arteries, radiographic images were obtained after the anterior abdominal wall was removed surgically. Subsequently, the anterior abdominal walls of the cadavers were dissected and measured by using metric and non-metric methods. In a majority of the cadavers (83.9%), the inferior epigastric artery had only one main stem. Between the umbilicus and the xiphoid process, the most common type of the anastomosis was multiple anastomoses (Type IV, in 32.1% of the cases), followed by no anastomosis (Type I) and single anastomosis (Type II) in 25% of the cases, respectively. The intramuscular branch of the inferior epigastric artery originated from below the umbilicus in 60.7% of the cases and above it in 39.3% of the cases. The peritoneal branch was further divided into 3 types: lateral, medial, and umbilical. One of them coexisted with other branch of specimen. The peritoneal branch commonly originated from the intramuscu-lar branch. The perforating branch, with an external diameter of greater than 0.5 mm, was clinically significant, was dis-tributed around the umbilicus. The number of arterial branches directly perforating the rectus abdominis muscle was greater than that of those traveling anteriorly. The results of this study may enhance the anatomical knowledge of clinicians with respect to flap surgery or surgical treatments involving the anterior abdominal wall.

Appearance of the Cleidohyoideus Muscle Combined with the Multiple Variations of the Infrahyoid Muscle / 대한해부학회지

Multiple variations of the infrahyoid muscle combined with appearance of cleidohyoideus muscle were found in a Korean male cadaver (age : 82) in a routine dissection. In this case, the hyoid bone descended to the level of the upper half of the thyroid cartilage. Then, the mylohyoid, stylohyoid and geniohyoid muscles, which attach to the hyoid bone, descended to the same level. An unusual cleidohyoideus muscle attached from the superior border of the medial third of the clavicle to the hyoid bone was observed bilaterally at the superficial layer. At deeper layer, the sternohyoid muscle, which was additionally attached to the first rib as well as sternum and clavicular head, appeared bilaterally. In the same layer, the left omohyoid muscle was partially merged to the muscle mass of sternohyoid and attached to the hyoid bone. In the deepest layer, the sternothyroid muscle was attached to the medial half of the first rib. The nerves that innervated this infrahyoid muscle originated from the cervical plexus, devoid of the ansa cervicalis.

Arterial Variation in Upper Limb: Case Report / 체질인류학회지

The arterial variations of the upper limb are frequently encountered in the human body. However, the appearance of multiple variations in one limb is uncommon. The present arterial variations were found in the right upper limb of 86 years-old female cadaver during a routine dissection. The variations of the arterial patterns are as follows: 1. Two thyrocervical trunks from subclavian artery and the internal thoracic artery is rising from lateral branch of thyrocervical trunks. 2. Thoracoacromial artery was divided two branches and the lateral thoracic artery arises from the small of two branches. 3. The distance of bifurcation of the brachial artery is 14.9 mm from the inferior border of teres major muscle. Medial branch of the brachial artery passes along the median nerve and becomes radial artery. Lateral branch of the brachial artery passes along the median nerve and becomes ulnar artery. 4. Bifurcation of radial artery is occurred at the distance of 46.9 mm from styloid process of radius. Deep palmar branch of radial artery is bifurcated on dorsum of hand. Branches for supplying first and second fingers arise from superficial palmar arch. The arterial variations of the upper limb could be caused a several bleeding in intravenous injection or surgeries and a wrong diagnosis. The knowledge of the arterial variation of the upper limb should be decreased to raise clinical problems.

Anatomic Variations of the Spinal Origins of the Main Terminal Branches of the Brachial Plexus / 체질인류학회지

Variations of spinal nerue compositions, which giue rise to the variable motor and sensory component, occured at the terminal branches of brachial plexus. This study performed to investigate the spinal nerve compositions of the main terminal branches of the brachial plexus in 32 sides of Korean adults. The main terminal branches contained the musculocutaneous, median, ulnar, radial and axillary nerves. The obtained results were as follows. The spinal nerve compositions of musculocutaneous nerve appeared as two types. The most frequent type was composed of C5, C6 and C7 at 75.0%. The mean diameter of C5 and C6 was 1.68+/-0.21 mm and 1.66+/-0.40 mm, respectively. The median nerve appeared as two types. The most frequent type was composed of C6, C7, C8, T1 components at 87.5%. The mean diameter of C7 was the thickest at 2.64+/-0.48 mm and C5 was most thin at 0.28+/-0.04 mm. The ulnar nerve appeared as four types. The most frequent type was comprised with C7, C8 and T1 at 75.0%. In the mean diameter, C8 was the thickest with 2.64+/-0.57mm and T1 was most thin with 0.06+/-0.56 mm. The radial nerve appeared as four types. The most frequent type was comprised from C5 to T1 at 43.7%. In the mean diameter, C7 was the thickest at 2.70+/-0.52 mm. The axillary nerve appeared as two types. The frequentest type was comprised with C5, C6 and C7 at 56.2%. In the mean diameter, C6 was the thickest at 1.73+/-0.56 mm. From the obtained results, spinal nerve compositions of the main terminal branches of the brachial plexus were more variable than the description of the anatomic textbook.

Short-term Results of Anterior Cervical Fusion with Cylindrical Cage(AMSLU(TM))

OBJECTIVE: The AMSLU(TM) cage is a newly developed instrument, that utilizes concept of the key-stone graft in posterior lumbar interbody fusion. The authors try to prove the short-term efficacy of AMSLU(TM) cage in surgical treatment of degenerative cervical disc disease. METHODS: We investigate clinical and radiological features of 24 patients who underwent anterior cervical fusion with AMSLU(TM) cage during the period between January 2001 and February 2002. Clinical and radiological results were assessed by using Odom's criteria and regular follow-up of radiographs, respectively. RESULTS: All patients included in this study had been followed by at least 6 months. Except 3 patients, all patients underwent single-level operation, and among remaining 21 patients, C5-6 was the most commonly involved level (17 cases). Symptomatic improvement was found in 22 cases (91%). Evidence of bone fusion was invariably found by the end of the postoperative 6 months in every case and increase of disc height was also shown in all patients. Neither operation-related nor instrument-related complications was seen. CONCLUSION: Anterior cervical fusion with AMSLU(TM) cage has several advantages over the preexisting instruments, such as easy maneurability, avoidance of donor site complications, and anatomical contour which renders it to endure lateral shearing force and its relatively large contact area.