Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing, PR China.
Med Hypotheses. 2011 Dec;77(6):1148-9. doi: 10.1016/j.mehy.2011.09.025. Epub 2011 Oct 19.
Lumbar foraminal stenosis is a common pathological change, and lumbar nerve root compression in stenotic foramina was recently considered as one of the main causes of low back pain and leg pain. However, the exact mechanism of lumbar nerve root compression in foramina is still not clear. Previous studies indicated that loss of the intervertebral disc height could reduce the cross-sectional area of lumbar foramina, while lumbar nerve root compression by boundaries of foramina has not been observed in experimental reduction of the intervertebral disc height. Given the close anatomic relationship between transforaminal ligaments and lumbar nerve roots, we hypothesize that transforaminal ligament can be the leading cause of lumbar nerve root compression in foraminal stenosis. We also propose that there are two possible mechanisms of lumbar nerve root compression by transforaminal ligaments: (1) nerve roots are compressed by the transforaminal ligament which moves downward with the loss of the intervertebral disc height; (2) pathological transforaminal ligaments increase the risk of nerve root compression in foramina.
腰椎侧隐窝狭窄是一种常见的病理变化，而狭窄侧隐窝内的腰椎神经根受压被认为是腰痛和腿痛的主要原因之一。然而，腰椎神经根在侧隐窝内受压的确切机制仍不清楚。既往研究表明，椎间盘高度的丧失会减小腰椎侧隐窝的横截面积，但在实验性椎间盘高度降低中并未观察到侧隐窝边界对腰椎神经根的压迫。鉴于脊神经根管外韧带与腰椎神经根之间的解剖关系非常密切，我们假设脊神经根管外韧带可能是侧隐窝狭窄中导致腰椎神经根受压的主要原因。我们还提出了脊神经根管外韧带导致腰椎神经根受压的两种可能机制：（1）随着椎间盘高度的丧失，脊神经根管外韧带向下移动，从而压迫神经根；（2）病变的脊神经根管外韧带增加了神经根在侧隐窝内受压的风险。
