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Sagittal close–up section through the
lateral recess of a severely degenerated lower cervical spinal
segment. The patient had complained of sensory disturbances
indicative of root compression at this level. Towards the center the
cartilaginous endplate of the disc has fused, posteriorly the disc
space is completely resorbed and bordered by amply vascularized
subchondral endplate sclerosis that extends posteriorly to form
endplate osteophytes or spondylophytes. These spondylophyes,
commonly referred to as "spurs" are always spondylosis flanges or
ridges that are connected by the hard remnant of the outermost
annulus fibrosus, thus forming a "beak" that pointedly compresses
the traversing root sleeve against the (unyielding) lamina of the
vertebra below. Contrary to the lumbar spine, compression in
degenerated cervical spines is caused almost entirely by bony
structures. Note also that the root sheath contains three roots (the
number of roots in the root sheath varies from two to five roots),
inferiorly the sagittally flattened root sleeve contains a small
amount of CSF. Due to the loss of disc height there also is a
retrolisthesis of the vertebra above, this is reflected on the more
posterior position of the lamina above and the superiorly receding
ligamentum flavum. |
©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Academic
University Hospital
Department of Orthopaedic Surgery
Uppsala, Sweden
Reproduction without permission is prohibited
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