Intradural communication between dorsal rootlets of spinal nerves: their clinical significance.
BACKGROUND
Anatomical and surgical textbooks give almost no attention to the intradural communications between dorsal rootlets of adjacent spinal nerves. These communications can be of significance in various neurosurgical procedures and clinical conditions of the region.


METHODS
The spinal cord of six formaldehyde-fixed cadavers was dissected from C1-S5. The dorsal rootlets of the spinal nerves were exposed via a posterior approach and communications between adjacent spinal nerves were documented.


RESULTS
The frequency of communication between adjacent dorsal rootlets of the spinal nerves showed variations among spinal levels. Thirty-eight dorsal rootlet communications were observed in six cadavers (12 sides) and 20 (52.6%) were at cervical levels, 14 (36.8%) at thoracic levels, and four (10.5%) at lumbar levels. The majority of communications were observed on the left side (65.8%). Communications were most frequently observed at cervical (C4-C5, C5-C6) and upper thoracic (T1-T2) levels and seen least frequently at lower thoracic and lumbar levels. No communications were observed at sacral levels. Five types of communication were observed: I. oblique ascending, II. oblique descending III. short Y, IV. long Y and V shaped. None of the communication extended beyond one segment at any spinal level. The occurrence of such dorsal rootlet communications ranged from 3 to 7 for each cadaver and the mean was 4.8 ± 1.3. Histological sections from various levels of the dorsal rootlet communications showed that all consisted of myelinated fibers of varying diameters.


CONCLUSIONS
Such communications may lead to misinterpretation of the pathology on the basis of clinical signs and symptoms and also should be considered in rhizotomy.
Department of Neurosurgery, Istanbul Education and Research Hospital, Istanbul, Turkey.
Bilgehan
B
Solmaz
Necati
N
Tatarlı
Davut
D
Ceylan
Evren
E
Keleş
Safiye
S
Çavdar
D000368:Aged; D002450:Cell Communication / Q000502:physiology*; D004388:Dura Mater / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019051:Rhizotomy; D013126:Spinal Nerve Roots / Q000033:anatomy & histology*; D013127:Spinal Nerves / Q000033:anatomy & histology*