Thoracic Nerves
The dorsal rami of the thoracic nerves run backward near the zygapophyseal joints, which they supply, and divide into medial and lateral branches. Both sets of branches pass through the…
Dermal Segmentation
The spinal cord is segmental in character, and the spinal nerves are distributed to structures developed from the associated segments, or metameres (see Plate 2-1). In the trunk, the correspondence…
Spinal Nerves
The upper cervical spinal nerves lie horizontally, but all the others assume an increasingly oblique and downward direction as they proceed to their foramina of exit. In the adult, the…
L4-5 Disk Extrusion
In patients in whom further treatment is necessary because of pain or neurologic deficit, surgery must be considered and must be preceded by imaging of the lumbosacral spine to rule…
Lumbosacral Spinal Stenosis
Spondylolisthesis, in which one vertebral body translates anteriorly or posteriorly with respect to an adjacent vertebral body, can also occur, exacerbating the spinal canal narrowing. The L4-5 level is most…
Lumbar Disk Herniation: Clinical Manifestations
The S1 root syndrome includes sciatic pain (“sciatica”) from the buttock to the posterior thigh, to the posterior or lateral calf, and into the foot. When due to disk herniation,…
Examination of Patient with Low Back Pain
As a result of abnormal movement at the facet joint, a hypertrophic, osteoarthritic process known as spondylosis develops. Enlargement of the facet joints by this spondylotic process narrows the intervertebral…
Radiographic Diagnosis of Radiculopathy
MRI effectively demonstrates the bony architecture of the spine, the contours of the intervertebral disk, the paraspinal soft tissues, and the contents of the spinal canal. Various MRI sequences can…
Cervical Disk Herniation
Etiology. Cervical disk disease is likely multifactorial, with contributing factors ranging from advancing age to neck trauma to heavy lifting to smoking. The nucleus pulposus in the middle of the…
