Intervertebral foramen in the context of "Lumbar spinal stenosis"

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👉 Intervertebral foramen in the context of Lumbar spinal stenosis

Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis. Lumbar spinal stenosis can cause pain in the low back or buttocks, abnormal sensations, and the absence of sensation (numbness) in the legs, thighs, feet, or buttocks, or loss of bladder and bowel control.

The precise cause of LSS is unclear. Narrowing of spinal structures in the spinal cord such as the central canal, the lateral recesses, or the intervertebral foramen (the opening where a spinal nerve root passes) must be present, but are not sufficient to cause LSS alone. Many people who undergo MRI imaging are found to have such changes but have no symptoms. These changes are commonly seen in people who have spinal degeneration that occurs with aging (e.g., spinal disc herniation). LSS may also be caused by osteophytes, osteoporosis, a tumor, trauma, or various skeletal dysplasias, such as with pseudoachondroplasia and achondroplasia.

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Intervertebral foramen in the context of Epineurium

The epineurium is the outermost layer of dense irregular connective tissue surrounding a peripheral nerve. It usually surrounds multiple nerve fascicles as well as blood vessels which supply the nerve. Smaller branches of these blood vessels penetrate into the perineurium. In addition to blood vessels which supply the nerve, lymphocytes and fibroblasts are also present and contribute to the production of collagen fibers that form the backbone of the epineurium. In addition to providing structural support, lymphocytes and fibroblasts also play a vital role in maintenance and repair of the surrounding tissues.

When the spinal nerve leaves the vertebral canal via an intervertebral foramen, two layers of the spinal meninges, the arachnoid and the dura invaginate the nerve to form a dural sleeve of connective tissue, which is the epineurium. The outer portion of this sleeve comprises the external epineurium which permits longitudinal nerve excursion and absorption of longitudinal stress. The layer of the epineurium that extends within the nerve to define the fascicles is termed the internal epineurium. Together, these two layers form the epineurium, which varies in thickness along the course of a nerve. The epineurium is usually most abundant around joints, as its function is to protect the nerves from stretching and subsequent injury. Epineurium is primarily made from collagen.

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