scholarly journals Anatomical Evaluation of Spinal Nerve and Cervical Intervertebral Foramina in Anterior Controllable Antedisplacement and Fusion Surgery: A Cadaveric and Radiologic Study

2021 ◽  
Author(s):  
Qing‐Jie Kong ◽  
Xiao‐Fei Sun ◽  
Zhi‐Yi Fu ◽  
Yuan Wang ◽  
Jing‐Chuan Sun ◽  
...  
Keyword(s):  
Spinal Nerve ◽  
Fusion Surgery ◽  
Radiologic Study ◽  
Intervertebral Foramina

scholarly journals Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments

2020 ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background:The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.Methods: The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.Results: The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.Conclusions: Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

scholarly journals Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments

2020 ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking. Methods The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement. Results The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range. Conclusions Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

scholarly journals Biomechanical study of the C5–C8 cervical extraforaminal ligaments

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qinghao Zhao ◽  
Yemei Yang ◽  
Penghuan Wu ◽  
Chengyan Huang ◽  
Rusen Zhang ◽  
...  
Keyword(s):  
Nerve Root ◽  
Bone Structure ◽  
Spinal Nerve ◽  
Biomechanical Study ◽  
Rate Of Change ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Load Range ◽  
Paravertebral Muscles ◽  
Intervertebral Foramina

Abstract Background The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking. Methods The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement. Results The displacement of the C5, C6, C7, and C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p < 0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range. Conclusions Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.

Biomechanics of the lumbar spinal nerve roots and the first sacral root within the intervertebral foramina

1989 ◽  
Vol 11 (3) ◽  
pp. 221-225 ◽  
Author(s):  
F. de Peretti ◽  
J. P. Micalef ◽  
A. Bourgeon ◽  
C. Argenson ◽  
P. Rabischong
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Lumbar Spinal ◽  
Intervertebral Foramina

scholarly journals A cadaveric microanatomical study of the fascicular topography of the brachial plexus

2016 ◽  
Vol 125 (2) ◽  
pp. 355-362 ◽  
Author(s):  
Sumit Sinha ◽  
G. Lakshmi Prasad ◽  
Sanjeev Lalwani
Keyword(s):  
Brachial Plexus ◽  
Suprascapular Nerve ◽  
Spinal Nerve ◽  
Cross Sectional ◽  
Spinal Nerves ◽  
Lateral Cord ◽  
Total Cross Sectional Area ◽  
Anatomical Localization ◽  
Intervertebral Foramina ◽  
Brachial Plexus Surgery

OBJECT Mapping of the fascicular anatomy of the brachial plexus could provide the nerve surgeon with knowledge of fascicular orientation in spinal nerves of the brachial plexus. This knowledge might improve the surgical outcome of nerve grafting in brachial plexus injuries by anastomosing related fascicles and avoiding possible axonal misrouting. The objective of this study was to map the fascicular topography in the spinal nerves of the brachial plexus. METHODS The entire right-sided brachial plexus of 25 adult male cadavers was dissected, including all 5 spinal nerves (C5–T1), from approximately 5 mm distal to their exit from the intervertebral foramina, to proximal 1 cm of distal branches. All spinal nerves were tagged on the cranial aspect of their circumference using 10-0 nylon suture for orientation. The fascicular dissection of the C5–T1 spinal nerves was performed under microscopic magnification. The area occupied by different nerve fascicles was then expressed as a percentage of the total cross-sectional area of a spinal nerve. RESULTS The localization of fascicular groups was fairly consistent in all spinal nerves. Overall, 4% of the plexus supplies the suprascapular nerve, 31% supplies the medial cord (comprising the ulnar nerve and medial root of the median nerve [MN]), 27.2% supplies the lateral cord (comprising the musculocutaneous nerve and lateral root of the MN), and 37.8% supplies the posterior cord (comprising the axillary and radial nerves). CONCLUSIONS The fascicular dissection and definitive anatomical localization of fascicular groups is feasible in plexal spinal nerves. The knowledge of exact fascicular location might be translatable to the operating room and can be used to anastomose related fascicles in brachial plexus surgery, thereby avoiding the possibility of axonal misrouting and improving the results of plexal reconstruction.

Chiropractic Intervention in the Treatment of Joint and Soft Tissue Disorders

1999 ◽  
Vol 24 (3) ◽  
pp. 279-289 ◽  
Author(s):  
John P. Crawford
Keyword(s):  
Manual Therapy ◽  
Scientific Evidence ◽  
Spinal Nerve ◽  
Joint Function ◽  
Chiropractic Treatment ◽  
Skilled Practitioner ◽  
Spinal Segments ◽  
Ancient Civilizations ◽  
Intervertebral Foramina ◽  
Low Amplitude

The concept of manual therapy, specifically manipulation of the bodily joints as in the practice of chiropractic, can no longer be deemed an invalid system of health care. Practiced for over 2,000 years by a variety of ancient civilizations, the art of manipulation for the purpose of correcting and restoring joint function has continued to fluorish, despite opposition. The climate, however, is changing. The art of chiropractic is increasingly being seen as a uniquely devised and administered technique whereby high velocity, low amplitude thrusting maneuvers are specifically directed by the skilled practitioner toward spinal segments and peripheral articulations in an effort to correct aberrant mechanical function. The corrections are effected while utilizing the transverse and spinal processes of individual vertebrae as contacting levers. Hippocrates is credited with the advice to, "Look well to the spine for the cause of disease," as displaced or degenerative vertebrae may irritate spinal nerve roots while exiting the intervertebral foramina and, consequently, interfere with normal nerve function. Similarly, it is a fundamental precept of chiropractic philosophy that irritation of the nervous system by mechanical, chemical, or psychogenic means is considered as causative in the development of disease. The scientific evidence associated with chiropractic intervention in the treatment and management of musculoskeletal disorders and visceral diseases is growing. This paper discusses the history, philosophy, and efficacy of joint manipulation and its influence on the development of chiropractic treatment. Key words: manipulation, mobilization, manual therapy

Rating Spinal Nerve Extremity Impairment Using the Sixth Edition

2009 ◽  
Vol 14 (4) ◽  
pp. 1-6
Author(s):  
Christopher R. Brigham
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Nerve Injuries ◽  
Sixth Edition ◽  
Federal Employee ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Rating Process

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, does not provide a separate mechanism for rating spinal nerve injuries as extremity impairment; radiculopathy was reflected in the spinal rating process in Chapter 17, The Spine and Pelvis. Certain jurisdictions, such as the Federal Employee Compensation Act (FECA), rate nerve root injury as impairment involving the extremities rather than as part of the spine. This article presents an approach to rate spinal nerve impairments consistent with the AMA Guides, Sixth Edition, methodology. This approach should be used only when a jurisdiction requires ratings for extremities and precludes rating for the spine. A table in this article compares sensory and motor deficits according to the AMA Guides, Sixth and Fifth Editions; evaluators should be aware of changes between editions in methodology used to assign the final impairment. The authors present two tables regarding spinal nerve impairment: one for the upper extremities and one for the lower extremities. Both tables were developed using the methodology defined in the sixth edition. Using these tables and the process defined in the AMA Guides, Sixth Edition, evaluators can rate spinal nerve impairments for jurisdictions that do not permit rating for the spine and require rating for radiculopathy as an extremity impairment.

Questions and Answers

2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Spinal Nerve ◽  
Sensory Loss ◽  
Residual Symptoms ◽  
Additional Information ◽  
Questions And Answers ◽  
Motor Nerves ◽  
Symptoms And Signs ◽  
Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

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