Changes of lumbosacral nerve roots innervation in lumbar disc
herniation patients with transitional vertebrae

doi:10.3969/j.issn.2095-4344.2401

Abstract

Abstract:

BACKGROUND: Lumbosacral transitional vertebra is a commonly seen congenital spinal deformity, and the changes in the muscle innervation pattern and the sensory dermatomes of the lumbosacral nerve roots have been reported, but the changes and its guidance significance for the surgeries of lumbar disc herniation have not been clarified systematically.

OBJECTIVE: To explore the possibility of changes in the muscle innervation pattern and the sensory dermatomes of the lumbosacral nerve roots when there is a lumbosacral transitional vertebra.

METHODS: The study was in accordance with the ethical requirements of Affiliated Hospital of Binzhou Medical University, and the subjects and their families signed the informed consents. The medical records of 321 patients with single segment lumbar disc herniation who underwent surgical treatment were analyzed retrospectively. Lumbosacral transitional vertebrae were present in 38 of 321 patients (11.8%). There were 26 cases of sacral lumbarization and 12 cases of lumbar sacralization. Among these 26 patients with sacral lumbarization, 23 had herniated discs at L₅/S₁ (L₆) compressing the S₁(L₆) nerve root. Of the 12 patients with lumbar sacralization, 8 had herniated discs at L_3/4 compressing the L₄ nerve root. In the 283 normally configured patients, 138 had herniated discs at L₅/S₁ compressing the S₁ nerve root, 95 had herniated discs at L₄/L₅ compressing the L₅ nerve root, and 47 had herniated discs at L₃/L₄ compressing the L₄nerve root. The preoperative symptoms of S₁ nerve root compression in the patients with sacral lumbarization and of L₄ nerve root compression in the patients with lumbar sacralization were compared with those of L₄, L₅or S₁ nerve root compression in the patients with normal configuration.

RESULTS AND CONCLUSION: (1) The distribution of motor function depression caused by S₁ nerve root compression was significantly different between sacral lumbarization patients group and normal group (P < 0.05). (2) The distribution of motor function depression caused by L₄ nerve root compression was also significantly different between lumbar sacralization patients group and normal group (P < 0.05). (3) The motor function depression caused by S₁ nerve root compression in sacral lumbarization patients was similar to that of the L₅ nerve root compression in the normal configuration, while the motor function depression caused by L₄nerve root compression in lumbar sacralization patients was similar to that of the L₅nerve root compression in the normal configuration. The analysis of the sensory dermatomes also showed similar results. (4) Our results suggest that the function of lumbosacral nerve roots changes in patients with transitional vertebrae. The S₁ nerve roots in patients with sacral lumbarization tend to serve the usual function of L₅ nerve roots (nerve roots move up), and the L₄ nerve roots in patients with lumbar sacralization tend to serve the usual function of L₅nerve roots (nerve roots move down).

Key words: lumbosacral transitional vertebrae, lumbosacral nerve roots, distribution variation, lumbar disc herniation

CLC Number:

Wang Xin, Wang Dawei, Sun Yiqiang, Zhao Zihao, Dou Yongfeng, Hu Peng, Geng Xiaopeng. Changes of lumbosacral nerve roots innervation in lumbar disc herniation patients with transitional vertebrae[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(5): 741-746.

Figures/Tables 15

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