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Microsurgical anatomy of the dorsal thoracic rootlets and dorsal root entry zones

  • Experimental research
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Abstract

Background

For successful DREZ (dorsal root entry zone) surgery, optimal neuroanatomical orientation and precise microsurgical dissection are required. Although cervical, lumbar, and sacral spinal segments have been studied in detail, such information is not available for thoracic segments. The objective of this anatomical study is to comprehensively illustrate the microanatomical features of the thoracic DREZs and their variations.

Methods

Fifteen formalin-fixed adult cadaveric spinal cords from T1 to T12 were used. The dorsal rootlet numbers, distance between the posteromedial and posterolateral sulcus, length of each DREZ, length of each segment, and mean length of the dorsal rootlets were measured under a surgical microscope.

Results

The longest DREZs were observed at the T6, T7, and T8 segments with mean values of 15.3 mm, 15.6 mm, and 15.4 mm, respectively. The longest segment was observed at the T10 segment with a mean value of 21.0 mm, and the shortest segment was observed at the T1 segment with a mean value of 13.5 mm.

Conclusions

The highest dorsal rootlet density is at the T1 segment of the spinal cord, can be easily distinguished visually, and may be a useful surgical landmark. The DREZs in T6-7 segments are longest, while these two segments have the least number of rootlets. Because the dorsolateral tract is remarkably narrow and the dorsal horn is exceedingly deep, DREZ surgery at the thoracic level may be difficult and risky for the dorsal column and corticospinal tract. Acquaintance with the microanatomy of the DREZ in the thoracic spinal cord is crucial to DREZ surgery.

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Acknowledgments

We would like to acknowledge Yucel Kanpolat, M.D., whose guidance was invaluable, and Gregory Kujoth, PhD, for carefully reading and editing the manuscript.

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Authors and Affiliations

  1. Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53792, USA

    Melih Bozkurt, Suat Canbay, Gabriel F. Neves, Erinç Aktüre, Emin Fidan & Mustafa K. Başkaya

  2. Departments of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53792, USA

    M. Shahriar Salamat

  3. Department of Neurological Surgery, University of Wisconsin, School of Medicine, CSC K4/822, 600 Highland Avenue, Madison, WI, 53792, USA

    Mustafa K. Başkaya

Authors
  1. Melih Bozkurt
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  2. Suat Canbay
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  3. Gabriel F. Neves
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  4. Erinç Aktüre
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  5. Emin Fidan
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  6. M. Shahriar Salamat
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  7. Mustafa K. Başkaya
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Correspondence to Mustafa K. Başkaya.

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Bozkurt, M., Canbay, S., Neves, G.F. et al. Microsurgical anatomy of the dorsal thoracic rootlets and dorsal root entry zones. Acta Neurochir 154, 1235–1239 (2012). https://doi.org/10.1007/s00701-012-1395-0

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  • DOI: https://doi.org/10.1007/s00701-012-1395-0

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