Intradural communication between dorsal rootlets of spinal nerves: their clinical significance

Solmaz, Bilgehan; Tatarlı, Necati; Ceylan, Davut; Keleş, Evren; Çavdar, Safiye

doi:10.1007/s00701-015-2425-5

Cited by 12 publications

(10 citation statements)

References 25 publications

(39 reference statements)

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“…5). Formation of inter-root anastomoses, which represent myelinated fibers connecting dorsal roots, has been related to undivided neural crest tissue along the spinal cord (27)(28)(29). This anatomical connectivity may explain overlapping of the sensory symptoms caused by nerve root compression (29).…”

Section: Variation In Spinal Cord Gross Anatomymentioning

confidence: 99%

Segment-Specific Orientation of the Dorsal and Ventral Roots for Precise Therapeutic Targeting of Human Spinal Cord

Mendez

Islam

Latypov

et al. 2021

Mayo Clinic Proceedings

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Section: Variation In Spinal Cord Gross Anatomymentioning

confidence: 99%

Segment-Specific Orientation of the Dorsal and Ventral Roots for Precise Therapeutic Targeting of Human Spinal Cord

Mendez

Islam

Latypov

et al. 2021

Mayo Clinic Proceedings

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“…In the five investigated cords, only one minute bi‐insertional anterior fila radicularia was found, and Solmaz et al. () reported none in six cords. The following hypothesis considers primarily the embryonic geometry.…”

Section: Discussionmentioning

confidence: 85%

“…; Solmaz et al. ), but within the geometric ‘merger model’ of Fig. A, all of these types emerge naturally from the same cause.…”

Section: Discussionmentioning

confidence: 96%

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Revisiting the segmental organization of the human spinal cord

Leijnse

D’Herde

2016

Journal of Anatomy

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In classic anatomic atlases, the spinal cord is standardly represented in its anatomical form with symmetrically emerging anterior and posterior roots, which at the level of the intervertebral foramen combine into the spinal nerves. The parts of the cord delimited by the boundaries of the roots are called segments or myelomeres. Associated with their regular repetitive appearance is the notion that the cord is segmentally organized. This segmental view is reinforced by clinical practice. Spinal cord roots innervate specific body parts. The level of cord trauma is diagnosed by the de-innervation symptoms of these parts. However, systemically, the case for a segmentally organized cord is not so clear. To date, developmental and genetic research points to a regionally rather than a segmentally organized cord. In the present study, to what degree the fila radicularia are segmentally implanted along the cord was investigated. The research hypothesis was that if the fila radicularia were non-segmentally implanted at the cord surface, it would be unlikely that the internal neuron stratum would be segmented. The visual segmented aspect of the myelomeres would then be the consequence of the necessary bundling of axons towards the vertebral foramen as the only exits of the vertebral canal, rather than of an underlying segment organization of the cord itself. To investigate the research hypothesis, the fila radicularia in the cervical-upper thoracic part of five spinal cords were detached from their spinal nerves and dissected in detail. The principal research question was if the fila radicularia are separated from their spinal nerves and dissected from their connective tissues up to the cord, would it be possible to reconstruct the original spinal segments from the morphology and interspaces of the fila? The dissections revealed that the anterior fila radicularia emerge from the cord at regular regionally modulated interspaces without systematic segmental delineations. The posterior fila radicularia are somewhat more segmentally implanted, but the pattern is individually inconsistent. The posterior and anterior roots have notable morphological differences, and hypotheses are presented to help explain these. The macroscopic observations are consistent with a regionally but not a segmentally organized cord. This conclusion was visually summarized in photographs of spinal cords with ipsilateral intact roots and contralateral individually dissected fila radicularia. It was suggested that this dual view of the spinal cord be added to the standard anatomic textbooks to counterbalance the current possibly biased view of a segmented cord.

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“…We can recognize the axillary nerve, the ulnar nerve, the median nerve, the musculocutaneous (or perforating Casserius) nerve, and the axillary nerve [16]. Before the nerves come out to form the ventral and dorsal roots, they form intradural anastomoses, throughout the spinal path excluding the sacral area; the area of C3-C6 is the cervical portion where these connections are most commonly found [18]. These connections with myelinated fibers are formed between dorsal rootlets and the spinal level below or above.…”

Section: Review Thoracic Outlet: Cervical Plexus and Sympathetic Cervmentioning

confidence: 99%

The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 2

Bordoni¹

2020

Cureus

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The main objective of the osteopath and that of osteopathic manipulative medicine (OMM) is to create space between the different tissues. The sliding capacity of the various tissue layers and between the different body components, up to the possibility of movement between cells is the salutogenic stimulus to allow the circulation of fluids, the biochemical exchange, and the adequate management of the multiple internal and external stimuli that perturb the body living. Movement is allowed by space and space is life. In this second part, the exposure of the anatomical neurological relationships of the five diaphragms continues, highlighting the relationships of the thoracic outlet, the respiratory diaphragm, and the pelvic floor. Finally, there will be clinical reflections to further corroborate the existence of the anatomical continuum and to lay the scientific foundations for an OMM approach to body diaphragms.

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Intradural communication between dorsal rootlets of spinal nerves: their clinical significance

Abstract: Such communications may lead to misinterpretation of the pathology on the basis of clinical signs and symptoms and also should be considered in rhizotomy.

Cited by 12 publications

References 25 publications

Segment-Specific Orientation of the Dorsal and Ventral Roots for Precise Therapeutic Targeting of Human Spinal Cord

Segment-Specific Orientation of the Dorsal and Ventral Roots for Precise Therapeutic Targeting of Human Spinal Cord

Revisiting the segmental organization of the human spinal cord

The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 2

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