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Anatomical study on the relationship between the dorsal root ganglion and the intervertebral disc in the lumbar spine.

Vialle E, Vialle LR, Contreras W, Jacob C - Rev Bras Ortop (2015)

Bottom Line: The measurements obtained were constant, without significant differences between levels or any laterality.Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.

ABSTRACT

Objective: To describe the location of the dorsal root ganglion in relation to the intervertebral disc, including the "triangular" safety zone for minimally invasive surgery in the lumbar spine.

Methods: Eight adult cadavers were dissected bilaterally in the lumbar region, using a posterolateral approach, so as to expose the L3L4 and L4L5 spaces, thereby obtaining measurements relating to the space between the intervertebral disc, pedicles cranial and caudal to the disc, path of the nerve root, dorsal ganglion and safety triangle.

Results: The measurements obtained were constant, without significant differences between levels or any laterality. The dorsal ganglion occupied the lateral border of the triangular safety zone in all the specimens analyzed.

Conclusion: Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.

No MeSH data available.


Related in: MedlinePlus

Comparative schematic appearance of the safety zones for the spinal nerve. (A) Choy et al.; (B) Mirkovic et al.; (C) Vialle et al. HDM, height of the dura mater; LN, length of the spinal nerve; DDMN, distance from the dura mater to the spinal nerve; HID, height of the intervertebral disc; P, pedicle of the vertebral arch; G, dorsal root ganglion (DRG); rectangular area in red represents the safety zone of the DRG.
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fig0015: Comparative schematic appearance of the safety zones for the spinal nerve. (A) Choy et al.; (B) Mirkovic et al.; (C) Vialle et al. HDM, height of the dura mater; LN, length of the spinal nerve; DDMN, distance from the dura mater to the spinal nerve; HID, height of the intervertebral disc; P, pedicle of the vertebral arch; G, dorsal root ganglion (DRG); rectangular area in red represents the safety zone of the DRG.

Mentions: In the present study, attention was paid to the safety limits of the DRG, which was located 7 mm from the exit point of the nerve root, usually in a location within the foramina. The distance from the intervertebral disc to the lower part of the nerve root was sufficient for a safe approach. The lower pedicle, which marks the lower limit of the safety zone, was located 5 mm from the DRG, i.e. differing from the findings of Mirkovic et al.13 and Choi et al.15 (Fig. 3).


Anatomical study on the relationship between the dorsal root ganglion and the intervertebral disc in the lumbar spine.

Vialle E, Vialle LR, Contreras W, Jacob C - Rev Bras Ortop (2015)

Comparative schematic appearance of the safety zones for the spinal nerve. (A) Choy et al.; (B) Mirkovic et al.; (C) Vialle et al. HDM, height of the dura mater; LN, length of the spinal nerve; DDMN, distance from the dura mater to the spinal nerve; HID, height of the intervertebral disc; P, pedicle of the vertebral arch; G, dorsal root ganglion (DRG); rectangular area in red represents the safety zone of the DRG.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563044&req=5

fig0015: Comparative schematic appearance of the safety zones for the spinal nerve. (A) Choy et al.; (B) Mirkovic et al.; (C) Vialle et al. HDM, height of the dura mater; LN, length of the spinal nerve; DDMN, distance from the dura mater to the spinal nerve; HID, height of the intervertebral disc; P, pedicle of the vertebral arch; G, dorsal root ganglion (DRG); rectangular area in red represents the safety zone of the DRG.
Mentions: In the present study, attention was paid to the safety limits of the DRG, which was located 7 mm from the exit point of the nerve root, usually in a location within the foramina. The distance from the intervertebral disc to the lower part of the nerve root was sufficient for a safe approach. The lower pedicle, which marks the lower limit of the safety zone, was located 5 mm from the DRG, i.e. differing from the findings of Mirkovic et al.13 and Choi et al.15 (Fig. 3).

Bottom Line: The measurements obtained were constant, without significant differences between levels or any laterality.Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.

ABSTRACT

Objective: To describe the location of the dorsal root ganglion in relation to the intervertebral disc, including the "triangular" safety zone for minimally invasive surgery in the lumbar spine.

Methods: Eight adult cadavers were dissected bilaterally in the lumbar region, using a posterolateral approach, so as to expose the L3L4 and L4L5 spaces, thereby obtaining measurements relating to the space between the intervertebral disc, pedicles cranial and caudal to the disc, path of the nerve root, dorsal ganglion and safety triangle.

Results: The measurements obtained were constant, without significant differences between levels or any laterality. The dorsal ganglion occupied the lateral border of the triangular safety zone in all the specimens analyzed.

Conclusion: Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.

No MeSH data available.


Related in: MedlinePlus