The Journal of Bone and Joint Surgery, Vol 64, Issue 5 721-729, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
Lumbosacral nerve-root anomalies
F Postacchini, S Urso and L Ferro
Forty-six cases of anomalous lumbosacral nerve roots were found in a series
of 2123 patients who underwent myelography with water-soluble contrast
medium. The anomalies were classified into five types. In Types I and II,
one or more nerve roots emerged from the theca at a more cranial (Type I)
or caudal (Type II) level than normal. In Type III, two or more roots
emerged through closely adjacent openings in the dura, whereas in Type IV
two nerve roots emerged from the dural sac combined as one nerve trunk. In
Type V, two roots were connected by an anastomotic branch shortly after
their emergence from the dura. The anomalies were usually unilateral and
the fifth lumbar and first sacral-nerve roots were the most frequently
involved. Type-III and Type-IV anomalies were the most common (69 per
cent). Twenty-one per cent of the patients had lumbosacral anomalies and
one had congenital absence of the articular facets of the lumbosacral joint
on the side of the nerve-root anomaly. In seven patients the anomalous root
or roots were compressed by a herniated disc, and the roots were entrapped
in a lateral recess or intervertebral foramen in two. Symptoms and signs of
nerve-root compression were usually severe, even in the patients with a
small disc protrusion. The severity of the clinical findings appeared to be
due to the reduced mobility of the anomalous roots. Adequate surgical
decompression led to satisfactory final results in all nine patients.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
