Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy
Conjoint nerve root (CNR) is an embryological nerve root anomaly that mainly involves the lumbosacral region. The presence of CNR during tubular discectomy raises the chances of failure in spinal surgery and the risk of neural injuries. Tubular discectomy can be challenging in the presence of CNR ow...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2021-08-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0250.pdf |
| _version_ | 1818718055441629184 |
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| author | Ayush Sharma Vijay Singh Romit Agrawal Nilesh Mangale Priyank Deepak Jeet Savla Ajay Jaiswal |
| author_facet | Ayush Sharma Vijay Singh Romit Agrawal Nilesh Mangale Priyank Deepak Jeet Savla Ajay Jaiswal |
| author_sort | Ayush Sharma |
| collection | DOAJ |
| description | Conjoint nerve root (CNR) is an embryological nerve root anomaly that mainly involves the lumbosacral region. The presence of CNR during tubular discectomy raises the chances of failure in spinal surgery and the risk of neural injuries. Tubular discectomy can be challenging in the presence of CNR owing to limited visualization. Here, we present a technical note on two cases of L5–S1 disc prolapse in the presence of conjoint S1 nerve root that was operated via a minimally invasive tubular approach. Any intraoperative suspicion of CNR while using the tubular approach should prompt the surgeon to perform a thorough tubular decompression prior to nerve root retraction. In patients with a large disc, disc should be approached via the axilla because the axillary area between the dura and the medial boarder of the root is very easy to approach in the presence of CNR. Safe performance of tubular discectomy is possible even in the presence of CNR in the lumbar spine. |
| first_indexed | 2024-12-17T19:44:58Z |
| format | Article |
| id | doaj.art-acb0be08276d4d14a3af3d0d2f415a3e |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-17T19:44:58Z |
| publishDate | 2021-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-acb0be08276d4d14a3af3d0d2f415a3e2022-12-21T21:34:54ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462021-08-0115454554910.31616/asj.2020.02501300Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular DiscectomyAyush Sharma0Vijay Singh1Romit Agrawal2Nilesh Mangale3Priyank Deepak4Jeet Savla5Ajay Jaiswal6Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaDepartment of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, IndiaConjoint nerve root (CNR) is an embryological nerve root anomaly that mainly involves the lumbosacral region. The presence of CNR during tubular discectomy raises the chances of failure in spinal surgery and the risk of neural injuries. Tubular discectomy can be challenging in the presence of CNR owing to limited visualization. Here, we present a technical note on two cases of L5–S1 disc prolapse in the presence of conjoint S1 nerve root that was operated via a minimally invasive tubular approach. Any intraoperative suspicion of CNR while using the tubular approach should prompt the surgeon to perform a thorough tubular decompression prior to nerve root retraction. In patients with a large disc, disc should be approached via the axilla because the axillary area between the dura and the medial boarder of the root is very easy to approach in the presence of CNR. Safe performance of tubular discectomy is possible even in the presence of CNR in the lumbar spine.http://www.asianspinejournal.org/upload/pdf/asj-2020-0250.pdfconjoined lumbosacral nerve rootslumbar disc herniationnerve root anomaliestubular discectomy |
| spellingShingle | Ayush Sharma Vijay Singh Romit Agrawal Nilesh Mangale Priyank Deepak Jeet Savla Ajay Jaiswal Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy Asian Spine Journal conjoined lumbosacral nerve roots lumbar disc herniation nerve root anomalies tubular discectomy |
| title | Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy |
| title_full | Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy |
| title_fullStr | Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy |
| title_full_unstemmed | Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy |
| title_short | Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy |
| title_sort | conjoint nerve root an intraoperative challenge in minimally invasive tubular discectomy |
| topic | conjoined lumbosacral nerve roots lumbar disc herniation nerve root anomalies tubular discectomy |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0250.pdf |
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