Background & Aim: Conjoined nerve root is defined as two adjacent nerve roots that share a common dural envelope at some points during their course from the thecal sac. This study reports our experience of conjoined roots involving three cases in Dakar. Methods & Materials/Patients: This is a consecutive study from 2013 to 2015 involving patients supported for disc herniation and who have presented conjoined nerve root anomalies. Results: Three patients aged 32, 35 and 55 including two men have been concerned. Clinical analysis was done on sciatica with neuropathic occurrences in one case and lumbosciatica in two cases. The Lasegue sign was present in two patients at 45°. All three patients benefited a lumbar computerized tomography (CT scan) highlighting a degenerative disc disease with two in L5S1 space and one in L4L5 space. The imaging has not objectified radicular emerging anomalies. MRI objectified only one big root. A surgical root decompression was realized through interlaminar discectomy approach; foraminotomy and full laminectomy enabling diagnosis in intraoperative period. The evolution was favourable in all three cases with full recession of symptomatology. Conclusion: This study is the first Senegalese series on the lumbo-sciatica by anomaly of root emergence and highlights especially the difficulties for the diagnosis of these anomalies like other sub-Saharan African countries where expansion of MRI for the diagnosis is low, and still very expensive. MRI provides guidance signs and a large root appearance can warn about the existence of these anomalies. A good root release improves the symptoms.
De découverte per-opératoire pour hernie discale, les anomalies d’émergence radiculaires constituent une entité rare. La présentation clinique est généralement identique à celle d'une radiculopathie. Nous rapportons le cas d'un patient âgé de 35 ans présentant une sciatique droite S1 hyperalgique rebelle aux multiples médications. L'IRM du rachis lombo-sacré avait mis en évidence une discopathie protrusive de petit volume en L5 S1 droite et un aspect de grosse racine ou de kyste de Tarlov au niveau de l’émergence droite de S1. Une fenestration inter lamaire L5-S1 droite avec une ablation du ligament jaune a montré une émergence radiculaire double au niveau de l'espace retro-discal. Un geste de foraminostomie a été réalisé sans discectomie. L’évolution a très favorable avec une rétrocession dès le lendemain. L'analyse pré-opératoire fine et rigoureuse de l'imagerie est indispensable. Une bonne libération améliore l’état clinique du patient. Y penser en cas de sciatique hyperalgique sans Lasègue.
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