The spine journal : official journal of the North American Spine Society
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The extraforaminal ligaments between the L5 and S1 lumbar spinal nerves and the tissues surrounding the intervertebral foramina have been well studied. However, little research has been undertaken to describe the local anatomy of the intraforaminal portion of the L5-S1 spine and detailed anatomical studies of the intraforaminal ligaments (IFLs) of the L5-S1 have not been performed. ⋯ The results demonstrate that IFLs are common structures in the IVF and that there are two types of IFLs: the transforaminal ligaments and the radiating ligaments. Transforaminal ligaments may be the potential cause of back pain. The radiating ligaments may contribute to dura laceration and epidural hemorrhage during endoscopic spinal adhesiolysis through the sacral hiatus, and an appreciation of this relationship might help reduce the risk of such complications.
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Intervertebral disc being avascular depends on nutrition from either the end plate or the annulus fibrosus (AF). The role of the end plate on disc diffusion had been extensively studied. However, diffusion of human AF remains poorly understood because of the lack of reliable techniques to study AF in vivo and non-invasively. The present study for the first time evaluates the 24-hour diffusion characteristics of AF in radial, axial, and circumferential directions. ⋯ Annulus fibrosus characteristically showed a "double-peak" pattern of diffusion. Both the peaks had different characteristics, confirming two different sources of nutrition. The initial peak was contributed by periannular vascularity and the delayed one via the end plate from the vertebral body. The fact that even AF depends on the end plate for nutrition helps us better understand the complex nutritional pathways of intervertebral discs.
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Damage to the spinal cord can result in irreversible impairments or complete loss of motor, sensory, and autonomic functions. Riluzole and magnesium have been widely investigated as neuroprotective agents in animal models of spinal cord injury. As these drugs protect the injured spinal cord through different mechanisms, we aimed to investigate if their neuroprotective efficacy could be cumulative. ⋯ Our results suggest that the combined treatment, although simultaneously targeting two excitotoxic-related mechanisms, did not further improve behavioral and histologic outcome when compared with riluzole given alone.