Abstract
Introduction
Juxtapositional tumors of the spinal nerve roots have been noted to not only interact with the roots at various vertebral levels, but also differ among patients. Therefore, the aim of the current study was to elucidate the potential for variation among the relationships of the meningeal layers at different nerve levels.
Methods
In 20 unembalmed adult cadavers and five fetal specimens, the spinal nerve roots from the cervical, thoracic, and lumbar regions were harvested with their associated meningeal layers and subjected to microdissection, histological analysis, or radiological imaging using 9.4-T MRI.
Results
As the nerve rootlets passed from the cord, they received their root sheath covering from the pia. After crossing the subarachnoid space to reach the apertures in the dura, they received two additional looser sheaths, an outer from the dura and an inner from the arachnoid. The pia mater always ended proximal to the arachnoid, and the pia and arachnoid layers extended more distally along the roots with caudal descent. Although the dorsal and ventral roots generally exited through separate dural openings, a single dural opening was also observed, often in the lower spinal regions. Thin intradural septations almost always separated the dorsal and ventral rootlets. The left and right sides frequently differed within individuals.
Conclusions
On the basis of our study, variations of the meninges surrounding the spinal nerve roots are common, but themes do exist. Such data support surgical observations of the different interactions between tumors in these regions with surrounding neural tissues.
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Acknowledgments
The authors would like to thank the donors of the anatomical specimens used in this study. Without their tremendous gift, the present study would not have been possible. Additionally, we would like to thank Dr. Paul McCormick, who brought to our attention the need for additional anatomical detail regarding the meningeal sheaths of the spinal nerves.
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Tubbs, R.S., Lobashevsky, A., Oakes, P. et al. Meningeal relationships to the spinal nerves and rootlets: a gross, histological, and radiological study with application to intradural extramedullary spinal tumors. Childs Nerv Syst 31, 675–681 (2015). https://doi.org/10.1007/s00381-015-2648-z
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DOI: https://doi.org/10.1007/s00381-015-2648-z