|
THORACOLUMBAR SPINE ANATOMY
AND PATHOLOGY
|
||||
|
Sagittal section through a degenerated lower lumbar spine of a 68yearold man with no history of back pain or radiculopathy. At L5S1 there is complete resorption of the intervertebral disc and stable fusion of the cartilaginous endplates that are bordered by a band of subchondral endplate sclerosis. Posteriorly the hard and dark outer annular layers are extruded into the midzone or pedicle portion of the root canal in which the relatively small dorsal root ganglion snugly follows the pedicle. The radicular artery is very small and that, despite the complete loss of segmental height, the segmental veins are not entirely collapsed. The total disc resorption also entails a severe shortening in the posterior elements as demonstrated here by the axial shortening subluxation of the facet joint. Its vertical, apparently less loaded facet, carries macroscopically normal hyaline cartilage whereas the tip of the upper articular process erodes into the inferior aspect of the pars interarticularis of L5. There is osteoarthrosis with osteophyte formation of the tip of the superior articular process.
|