Prevertebral Fascia

lamina prevertebralis fasciae cervicalis profundae

The prevertebral fascia is the deepest layer of the deep cervical fascia. It runs from the base of the skull down to about the level of T3, where it blends with the anterior longitudinal ligament, and it wraps the vertebral column and the muscles attached to it, including the longus colli, longus capitis and scalenes. It forms the floor of the posterior triangle and is carried into the axilla around the brachial plexus and subclavian artery as the axillary sheath.

Anatomical Data

Boundaries & Contents

Location	Back of the neck, in front of the vertebral column and its muscles
Boundaries	Above: base of the skull Below: blends with the anterior longitudinal ligament at about T3 Laterally: extends over the scalene muscles and forms the floor of the posterior triangle Continues into the axilla as the axillary sheath
Contents	Longus colli and longus capitis Scalene muscles and the deep muscles of the back of the neck Phrenic nerve on scalenus anterior Roots of the brachial plexus and the subclavian artery (leave within the axillary sheath)

Biomechanics

Function & Actions

Encloses the vertebral column and its muscles and forms the back wall of the danger space, limiting the spread of infection from the vertebrae forward.

Clinical Relevance

Clinical Notes

The prevertebral fascia forms the posterior wall of the retropharyngeal space, allowing retropharyngeal abscesses to be confined before rupturing. In anterior cervical spine surgery, the prevertebral fascia must be opened along the anterior longitudinal ligament to access the cervical disc and vertebral bodies. Infection tracking along the prevertebral fascia can spread to the thoracic spine without producing mediastinitis. The axillary sheath derived from prevertebral fascia is the target for interscalene and axillary brachial plexus blocks.

Pathology

Common Injuries & Conditions

Retropharyngeal Abscess Posterior to Prevertebral Fascia

Infection reaching the retropharyngeal space between the alar fascia anteriorly and the prevertebral fascia posteriorly produces a retropharyngeal abscess with fever, dysphagia, and anterior bulging of the posterior pharyngeal wall; CT confirms the abscess and management requires drainage either transorally or through an external cervical approach.

Explore

More in Neck

Browse all of Neck →