title: Intra-operative identification of conjoined lumbosacral nerve roots: a report of three cases.
abstract: We report 3 cases of conjoined nerve root anomalies identified during micro-endoscopic discectomy (MED). Between 2009 and 2010, 61 men and 20 women aged 18 to 84 (mean, 42) years underwent MED for symptomatic lumbar disc herniation of L3-4 (n=1), L4-5 (n=44), and L5-S1 (n=36). Magnetic resonance imaging (MRI), myelogram, and postmyelo computed tomography did not identify the anomalies. All 3 patients were male and had type 2A S1 conjoined nerve roots, with a herniated disc at L5-S1. None of them had any preoperative pseudolocalising neurological signs, but all demonstrated stiffer positive straight leg raise sign and deterioration of the Achilles tendon reflex. Postoperatively, all 3 patients achieved excellent clinical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan. uchiro1968@mac.com
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Morishita
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohta
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Shiba
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D017586:Diskectomy; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D013126:Spinal Nerve Roots / Q000002:abnormalities*