Sagittal close–up section through the
level of the lateral recess of a severely degenerated lower cervical
spine of a completely asymptomatic 64–year–old woman. The vertebra
in the center is C5. Both adjacent discs are degenerated with a
roughly 50% decrease in height and internal disruption of the
annulus fibrosus and absence of a nucleus pulposus. At C4–C5 the
disc height reduction is more pronounced and small spondylosis
endplate osteophytes are seen anteriorly and posteriorly. Behind the
disc the root sleeve traverses the lateral recess, there is no
compression of the root sleeve which carries cerebrospinal fluid
surrounding the nerve roots, the epidural veins are wide and patent.
At C5–C6 there is an extruded disc. This teardrop–shaped fragment
completely obliterates the lateral recess and compresses the root
sleeve (also emptying its CSF content) and also displaces the root
inferiorly. While it is questionable whether the disc fragment still
is contained posteriorly, it still is in continuity with the
substance of the disc anteriorly. The upper portion of the herniated
disc has dissected its way underneath the periosteum of the vertebra
above. There also is a slight infolding of the liagamentum flavum.
©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Department of Orthopaedic Surgery
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