Summary
The authors undertook a morphometric study of the intervertebral foramina in anatomic specimens of spines unaffected by degenerative lesions. They studied the variations in shape and size of 38 intervertebral foramina during flexion-extension movements and following an isolated disc collapse. The cast technique takes into account the bony prominences, the bulge of the disc anteriorly and of the capsulo-ligamentous structures posteriorly. In flexion, all the diameters of the foramina are maximal. In full extension all the diameters decrease significantly: the pedicles come closer together, the disc bulges posteriorly and the ligamentum flavum is pushed forward by the superior articular process of the underlying vertebra. A disc collapse of 4 mm decreases all the diameters, and in this case lumbar extension results in a sufficient decrease of foraminal diameter to threaten the nerve root.
Résumé
Les auteurs ont effectué une étude des foramen intervertébraux sur des préparations anatomiques de rachis indemne de toutes lésions pathologiques dégénératives. Ils ont étudié des variations de forme et de taille de 38 foramen intervertébraux au cours des mouvements de flexion-extension, avant et après affaissement discal isolé. La technique utilisêe a pris en compte les reliefs osseux, le bord antérieur du disque et les structures capsuloligamentaires postérieures. En flexion, tous les diamètres du foramen sont maximum. En extension extrême, tous les diamètres diminuent de façon significative: les pédicules se rapprochent, le disque fait saillie en arrière et le ligament jaune est poussé en avant par le processus articulaire supérieur de la vertèbre sous-jacente. Un affaissement discal de 4 mm réduit tous les diamètres du foramen. Il apparaît donc qu'après affaissement discal, l'hyperextension lombaire rétrécit suffisamment le diamètre du foramen pour menacer la racine nerveuse.
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Mayoux-Benhamou, M.A., Revel, M., Aaron, C. et al. A morphometric study of the lumbar foramen. Surg Radiol Anat 11, 97–102 (1989). https://doi.org/10.1007/BF02096463
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DOI: https://doi.org/10.1007/BF02096463