Hernias. Radicular compression.
Welcome to the channel.
Today we'll talk about herniated discs and their locations. That is, the areas where compression most often occurs.
There are four levels at which nerve fiber compression can occur in patients with radiculopathy symptoms.
Disc level (central)
This is the site where nerve fiber compression most often occurs – primarily due to a herniated disc and, less commonly, due to spinal stenosis (Porter, 1976; Radhakrishnan, 1994; Melancia, 2014; Cohen, 2015).
Lateral recess level
This is the area beneath the disc, where the nerve fibers are located more laterally, shifting toward the intervertebral foramen. Narrowing of the lateral recess can be caused by facet joint osteoarthritis, usually in combination with ligamentum flavum hypertrophy and disc herniation (Jaumard, 2011).
Foraminal Zone
This is the area between the pedicles of the vertebrae above and below, where nerve fibers exit the spinal canal. Narrowing of the intervertebral foramen is observed with facet joint osteoarthritis, spondylolisthesis, and foraminal disc herniation—usually due to disc migration from a lower level (Ehsanian, 2021).
Extraforaminal Zone
This is the area lateral to the intervertebral foramen. Nerve compression in this area is rare, but is sometimes caused by lateral disc herniation (Ehsanian, 2021).
A combination of these lesions can occur in the same patient. For example, a herniated disc can cause nerve compression at the disc level, as well as at the foraminal or extraforaminal space. This occurs when the disc contents migrate.
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