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RELATIONS OF NERVE ROOTS TO ABNORMALITIES OF LUMBAR AND CERVICAL PORTIONS OF THE SPINE

RELATIONS OF NERVE ROOTS TO ABNORMALITIES OF LUMBAR AND CERVICAL PORTIONS OF THE SPINE Abstract THE FINDING of diagnostic areas of sensory reduction, or hypalgesia, with loss of a single nerve root has made possible the accurate identification and location of nerve roots in their relation to vertebral sequence and abnormality. From this study it has been found that each nerve root maintains a constant position in the total series of vertebrae, regardless of a variable number of ribs or of transitional types of vertebrae. This observation is of considerable importance in the interpretation of nerve root syndromes in relation to lesions of the spine, particularly in the localization of posterolateral herniation of an intervertebral disk. It has made unnecessary the use of the spinogram in the great majority of typical cases and has clarified some misinterpretations of anatomic and pathologic variations of the spine not related to symptoms of nerve root involvement. This paper is presented in support of these statements and is based References 1. Keegan, J. J.: (a) Dermatome Hypalgesia Associated with Herniation of Intervertebral Disk , Arch. Neurol. & Psychiat. 50:67 ( (July) ) 1943 2. (b) Neurosurgical Interpretation of Dermatome Hypalgesia with Herniation of Lumbar Intervertebral Disc , J. Bone & Joint Surg. 26:238 ( (April) ) 1944 3. (c) Diagnosis of Herniation of Lumbar Intervertebral Disks by Neurologic Signs , J.A.M.A. 126:868 ( (Dec. 2) ) 1944 4. (d) Dermatome Hypalgesia with Posterolateral Herniation of Lower Cervical Intervertebral Disc , J. Neurosurg. 4:115 ( (March) ) 1947. 5. Foerster, O.: The Dermatomes in Man , Brain 56:1 ( (March) ) 1933. 6. Sherrington, C. S.: Experiments in Examination of the Peripheral Distribution of the Fibers of the Posterior Roots of Some Spinal Nerves , Phil. Tr. Roy. Soc., London 184:641, 1893. 7. Bolk, L.: Die Segmentaldifferenzirung des menschlichen Rumpfes und seiner Extremitäten , Morphol. Jahrb. 26:91, 1898. 8. Keith, A.: The Extent to Which the Posterior Segments of the Body Have Been Transmuted and Suppressed in the Evolution of Man and Allied Primates , J. Anat. & Physiol. 37:18, 1902. 9. Hartman, C. G., and Straus, W. L.: The Anatomy of the Rhesus Monkey , Baltimore, Williams & Wilkins Company, 1933. 10. Todd, T. W.: Numerical Significance of the Thoracolumbar Vertebrae of the Mammalia , Anat. Rec. 24:261 ( (Dec.) ) 1922. 11. Sherrington, C. S.: Notes on the Arrangement of Some Motor Fibers in the Lumbosacral Plexus , J. Physiol. 13:621, 1892. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

RELATIONS OF NERVE ROOTS TO ABNORMALITIES OF LUMBAR AND CERVICAL PORTIONS OF THE SPINE

Archives of Surgery , Volume 55 (3) – Sep 1, 1947

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1947 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1947.01230080252002
Publisher site
See Article on Publisher Site

Abstract

Abstract THE FINDING of diagnostic areas of sensory reduction, or hypalgesia, with loss of a single nerve root has made possible the accurate identification and location of nerve roots in their relation to vertebral sequence and abnormality. From this study it has been found that each nerve root maintains a constant position in the total series of vertebrae, regardless of a variable number of ribs or of transitional types of vertebrae. This observation is of considerable importance in the interpretation of nerve root syndromes in relation to lesions of the spine, particularly in the localization of posterolateral herniation of an intervertebral disk. It has made unnecessary the use of the spinogram in the great majority of typical cases and has clarified some misinterpretations of anatomic and pathologic variations of the spine not related to symptoms of nerve root involvement. This paper is presented in support of these statements and is based References 1. Keegan, J. J.: (a) Dermatome Hypalgesia Associated with Herniation of Intervertebral Disk , Arch. Neurol. & Psychiat. 50:67 ( (July) ) 1943 2. (b) Neurosurgical Interpretation of Dermatome Hypalgesia with Herniation of Lumbar Intervertebral Disc , J. Bone & Joint Surg. 26:238 ( (April) ) 1944 3. (c) Diagnosis of Herniation of Lumbar Intervertebral Disks by Neurologic Signs , J.A.M.A. 126:868 ( (Dec. 2) ) 1944 4. (d) Dermatome Hypalgesia with Posterolateral Herniation of Lower Cervical Intervertebral Disc , J. Neurosurg. 4:115 ( (March) ) 1947. 5. Foerster, O.: The Dermatomes in Man , Brain 56:1 ( (March) ) 1933. 6. Sherrington, C. S.: Experiments in Examination of the Peripheral Distribution of the Fibers of the Posterior Roots of Some Spinal Nerves , Phil. Tr. Roy. Soc., London 184:641, 1893. 7. Bolk, L.: Die Segmentaldifferenzirung des menschlichen Rumpfes und seiner Extremitäten , Morphol. Jahrb. 26:91, 1898. 8. Keith, A.: The Extent to Which the Posterior Segments of the Body Have Been Transmuted and Suppressed in the Evolution of Man and Allied Primates , J. Anat. & Physiol. 37:18, 1902. 9. Hartman, C. G., and Straus, W. L.: The Anatomy of the Rhesus Monkey , Baltimore, Williams & Wilkins Company, 1933. 10. Todd, T. W.: Numerical Significance of the Thoracolumbar Vertebrae of the Mammalia , Anat. Rec. 24:261 ( (Dec.) ) 1922. 11. Sherrington, C. S.: Notes on the Arrangement of Some Motor Fibers in the Lumbosacral Plexus , J. Physiol. 13:621, 1892.

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1947

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