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Intradural communication between dorsal rootlets of spinal nerves: their clinical significance

  • Clinical Article - Neurosurgical Anatomy
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Abstract

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.

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Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership, or other equity interest, and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Istanbul Education and Research Hospital, Istanbul, Turkey

    Bilgehan Solmaz

  2. Department of Neurosurgery, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

    Necati Tatarlı

  3. Department of Neurosurgery, Sakarya University School of Medicine, Sakarya, Turkey

    Davut Ceylan

  4. Department of Neurosurgery, Koç University School of Medicine, Istanbul, Turkey

    Evren Keleş

  5. Department of Anatomy, Koç University School of Medicine, Istanbul, Turkey

    Safiye Çavdar

Authors
  1. Bilgehan Solmaz
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  2. Necati Tatarlı
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  3. Davut Ceylan
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  4. Evren Keleş
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  5. Safiye Çavdar
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Corresponding author

Correspondence to Safiye Çavdar.

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Comments

This is an interesting manuscript. The authors describe the anastomoses between dorsal rootlets of the spinal cord in six human cadavers. The sample size was small, but the point is very clear. It is not clear what the function and implication of this anomaly might be, but this was not the purpose of this study. The authors took the effort to also perform histopathology on these structures, finding them to be consistent with neural tissues that would be functional. Overall, the study is a provocative reminder of how variable the nervous system is anatomically.

Michael Wang

Florida, USA

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Solmaz, B., Tatarlı, N., Ceylan, D. et al. Intradural communication between dorsal rootlets of spinal nerves: their clinical significance. Acta Neurochir 157, 1069–1076 (2015). https://doi.org/10.1007/s00701-015-2425-5

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  • DOI: https://doi.org/10.1007/s00701-015-2425-5

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