Lumbar Pathology Foraminal Stenosis
Shows a lateral view of a normal and a degenerate L4-5 facet joint during flexion--extension. Also shows a superior view of the L4 nerve root during the natural progress of L5 facet joint arthropathy leading to foraminal stenosis. INTERVERTEBRAL FORAMEN The intervertebral foramen is formed posteriorly by the superior articular process of the vertebra below and the inferior articular process of the vertebra above, anteriorly by the vertebral bodies and the intervening intervertebral disc, and superiorly and inferiorly by the respective vertebral pedicles. The intervertebral foramen provides a protective exit tunnel for the spinal nerve to leave the spinal canal. FORAMINAL STENOSIS Foraminal stenosis refers to narrowing of the intervertebral foramina. It is commonly caused by a degenerative articular process enlargement posteriorly, anteriorly by posterolateral intervertebral disc bulging and posterolateral vertebral body lipping (osteophytes), and superiorly by the vertebral pedicle that moves inferiorly with intervertebral disc dehydration and collapse during degenerative disc disease. Less common causes of foraminal stenosis are spine tumours and infections, an expanding cervical synovial cyst and synovial chondromatosis. RADICULOPATHY Radiculopathy refers to the symptomatic dysfunction of the spinal nerve roots in the spinal canal or in the intervertebral foramen, usually originating from compression, traction, inflammation or impaired blood supply. Symptoms are felt in ...
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