Lumbosacral Nerve Root Anomaly Associated With Spondylolisthesis in an Adolescent: A Case Report and Review of the Literature

Davidson, Darin; Rowan, Robert L.; Reilly, Christopher W.

doi:10.1097/01.brs.0000232808.09107.f4

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…5,6,14,15,21 Another clue, although not confirmed by other authors, might be the absence of normal ligamentum flavum, as seen in Case 1.…”

Section: Management Of Nerve Root Anomalies During Tlifmentioning

confidence: 75%

“…If increasing the height of the intervertebral foramen is not necessary, one could consider using a bilateral pedicle screw construct without an interbody graft. 6 …”

Section: Management Of Nerve Root Anomalies During Tlifmentioning

confidence: 99%

“…5,6,30,31 One operation that is used to treat these conditions is TLIF. 24 Given that Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system anomalies are frequently not identified on preoperative images, injury to an unrecognized anomalous nerve root can easily occur during lumbosacral decompression and fusion operations.…”

mentioning

confidence: 99%

“…6,30 However, neither article clearly addresses strategies to both identify these anomalies and avoid injuring the nerves during TLIF. Among 200 TLIFs performed by our senior author (R.I.R.…”

mentioning

confidence: 99%

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Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

Burke

Safain

Kryzanski

et al. 2013

FOC

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Lumbar nerve root anomalies are uncommon phenomena that must be recognized to avoid neural injury during surgery. The authors describe 2 cases of nerve root anomalies encountered during mini-open transforaminal lumbar interbody fusion (TLIF) surgery. One anomaly was a confluent variant not previously classified; the authors suggest that this variant be reflected in an amendment to the Neidre and Macnab classification system. They also propose strategies for identifying these anomalies and avoiding injury to anomalous nerve roots during TLIF surgery. Case 1 involved a 68-year-old woman with a 2-year history of neurogenic claudication. An MR image demonstrated L4–5 stenosis and spondylolisthesis and an L-4 nerve root that appeared unusually low in the neural foramen. During a mini-open TLIF procedure, a nerve root anomaly was seen. Six months after surgery this patient was free of neurogenic claudication. Case 2 involved a 60-year-old woman with a 1-year history of left L-4 radicular pain. Both MR and CT images demonstrated severe left L-4 foraminal stenosis and focal scoliosis. Before surgery, a nerve root anomaly was not detected, but during a unilateral mini-open TLIF procedure, a confluent nerve root was identified. Two years after surgery, this patient was free of radicular pain.

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“…5,6,14,15,21 Another clue, although not confirmed by other authors, might be the absence of normal ligamentum flavum, as seen in Case 1.…”

Section: Management Of Nerve Root Anomalies During Tlifmentioning

confidence: 75%

“…If increasing the height of the intervertebral foramen is not necessary, one could consider using a bilateral pedicle screw construct without an interbody graft. 6 …”

Section: Management Of Nerve Root Anomalies During Tlifmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

Burke

Safain

Kryzanski

et al. 2013

FOC

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“…This implies that muscles and dermatomes may be innervated not only by axons of one spinal segment, but also partly by axons of adjacent levels. Moreover, a number of nerve root anomalies such as conjoined nerve roots or nerve root anastomoses have been documented in the lumbosacral region in clinical, radiological and anatomical series 55 67. Thus, clinical abnormalities may be attributable to either anatomical abnormalities or variations in segmental distribution of spinal nerve roots.…”

Section: Discussionmentioning

confidence: 99%

Segmental innervation in lumbosacral transitional vertebrae (LSTV): a comparative clinical and intraoperative EMG study

Hinterdorfer

Parsaei²,

Stieglbauer³

et al. 2010

Journal of Neurology, Neurosurgery & Psychiatry

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Nerve root anomalies: making sense of a complicated literature

et al. 2017

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Lumbosacral Nerve Root Anomaly Associated With Spondylolisthesis in an Adolescent: A Case Report and Review of the Literature

Abstract: This case emphasizes the need to consider the presence of lumbosacral nerve root anomalies in cases in which neurologic findings exceed what would be anticipated. Preoperative identification of these anomalies allows for their existence to be considered in the surgical plan.

Cited by 9 publications

References 15 publications

Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

Segmental innervation in lumbosacral transitional vertebrae (LSTV): a comparative clinical and intraoperative EMG study

Nerve root anomalies: making sense of a complicated literature

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