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The Boundaries Of The Lumbar Spine Neuroforamen, And Their Changes With Age And Degeneration. 2004

Sattenberg, Ronald, M.D., Srinivas, Gujjarappa, M.D., Goud, Ajay, M.D., Bergmann, Alan, M.D., Rafal, Richard, M.D. Bettmann, Michael, M.D.

Purpose:
The boundaries of the lumbar spine neuroforamen are composed of pedicle, posterior element portions, disk material, and posterior aspects of vertebral bodies. With aging, the proportions of the different elements which comprise the neuroforaminal boundaries change. This is a function of degenerative bony changes, such as facet hypertrophy, ligamentous hypertrophy, disk degeneration, and compression deformities of the vertebral bodies. Similarly, with disk disease these proportions will change as well. It is the goal of this case series to illustrate the changes describe d above, as well as to elaborate on the multiple etiologies for neuroforaminal stenosis with aging and degenerative processes.

Methods and Materials:
A case series study was performed whereby lumbar neuroforamen were analyzed for changes of aging and degeneration. These changes were compiled and are presented.

Results and Conclusions:
With aging-, degeneration-, and disk disease-, the components of the boundaries comprising the neuroforamen change. To some degree, the effects of these changes are somewhat predictable. Along with these changes, come the associated potential clinical syndromes. Similarly, with the degenerative changes and associated narrowing of the neuroforamen, the clinical consequences of disk herniations and herniated nucleus pulposus are usually more prominent.

This exhibit illustrates these changes, and makes one aware of the bony and disk changes that contribute to neuroforaminal narrowing with aging and degeneration.