Fibrous structures in the subarachnoid space: a study with spinaloscopy in autopsy subjects

Area of Science:

• Neurosurgery
• Anatomy
• Spinal Cord Imaging

Background:

• The subarachnoid space contains nerve roots and cerebrospinal fluid.
• Understanding its anatomy is crucial for spinal procedures.
• Variations in this space can affect surgical outcomes.

Purpose of the Study:

• To investigate the anatomical variations within the lumbar and lower thoracic subarachnoid space.
• To identify fibrous attachments and their impact on nerve root mobility.
• To explore potential links between these findings and subarachnoid block complications.

Main Methods:

• Rigid endoscopy (spinaloscopy) was utilized.
• The lumbar and lower thoracic subarachnoid space of 26 human autopsy subjects was examined.
• Detailed observations of nerve roots and surrounding membranes were recorded.

Main Results:

• Fibrous attachments between nerve roots and the arachnoid membrane were present in 16 subjects.
• Restricted nerve root mobility was observed in nine subjects.
• Distinct membranous structures were identified in three subjects, potentially impeding needle or endoscope passage.

Conclusions:

• Anatomical variations, including fibrous attachments, exist in the subarachnoid space.
• These variations can restrict nerve root mobility, potentially causing complications.
• Findings may explain variations in subarachnoid block extent and nerve root trauma risk.