The relationship of structural pathology to the nerve root. x

---

Kirkaldy-Willis WH. x Spine. [JC:uxk] 9(1):49-52, 1984 Jan-Feb. x Lumbar spinal nerves may be entrapped (a) at the back of the disc (b) x laterally in the central canal, (c) in the cauda equina, (d) more x laterally in the nerve canal, and (e) posteriorly in the zygapophyseal x joints. There is a spectrum of degenerative change in both joints and x disc. Changes at these three sites can produce (a) dysfunction, (b) disc x herniation, (c) instability, (d) lateral entrapment, and (e) central x stenosis. The clinical significance is that many patients become symptom x free on nonoperative treatment. Some with nerve entrapment require x decompression. Those with instability may need a fusion. The pain from a x disc lesion or from stenosis may come from irritation and inflammation of x the dura. The motor loss in these lesions may be due to reflex inhibition x and vascular insufficiency rather than from nerve compression. It is x vitally important to identify accurately the nerve that is entrapped. x