Conjoined lumbar nerve roots: a frequently underappreciated congenital abnormality.
Nerve root anomalies are frequently underrecognized on advanced imaging studies and may account for some percentage of failed spinal surgical procedures. The conjoined nerve root represents the most common nerve root anomaly. It is a well-known cause of false-positive readings for bulging and herniated disks in patients with purely axial neuroimaging studies. A retrospective evaluation of consecutive microsurgical lumbar diskectomies in 80 patients during a 5-year period was undertaken. A total of four patients (5%) were found intraoperatively to have evidence of a conjoined nerve root by the classification of Neidre. None was diagnosed preoperatively. Coronal magnetic resonance imaging offers the best means of visualizing a conjoined nerve root. The chance for a successful operation can be significantly enhanced if the surgeon is prepared to encounter this pathology.
Scuderi
Gaetano J
GJ
Parkway Regional Medical Center, Miami, Florida 33179, USA. scuderimd@aol.com
Vaccaro
Alexander R
AR
Brusovanik
Georgiy V
GV
Kwon
Brian K
BK
Berta
Scott C
SC
D000328:Adult; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology* / Q000517:prevention & control; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000002:abnormalities* / Q000000981:diagnostic imaging