Volume 1, Issue 3 (12-2015)                   Iran J Neurosurg 2015, 1(3): 21-25 | Back to browse issues page

‎ 10.18869/acadpub.irjns.1.3.21

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Diagnostic and Therapeutic Implications of Conjoined Nerve Root Anomalies: A Senegalese Study of Three Cases
Yannick Canton Kessely * 1, Ibrahima Tine2 , Maguette Gaye Sakho3 , Maguette Mbaye4 , Mahamoud Ali Meidal5 , Youssou Traore5 , Abdoul Azize Diop6 , Youssoupha Sakho7
1- MD, Neurosurgeon, Grand Yoff Hospital, Dakar, Senegal
2- MD, Neurosurgeon, Princioal Hosoital, Dakar, Senegal
3- MD, Neurosurgeon, Assistant Professor, Grand Yoff Hospital, Dakar, Senegal
4- MD, Neurosurgeon, Assistant Professor, Fann Hospital, Dakar, Senegal
5- MD, Neurosurgeon, Fann Hospital, Dakar, Senegal
6- MD, Professor of Neurosurgery, Head of Service of Neurosurgery, Department of Princioal Hosoital, Dakar, Senegal
7- MD, Professor of Neurosurgery, Head of Service of Neurosurgery, Department of Grand Yoff Hosoital
Abstract:   (5698 Views)

Background & Aim: Conjoined nerve root is defined as two adjacent nerve roots that share a common dural envelope at some points during their course from the thecal sac. This study reports our experience of conjoined roots involving three cases in Dakar.

Methods & Materials/Patients: This is a consecutive study from 2013 to 2015 involving patients supported for disc herniation and who have presented conjoined nerve root anomalie s.

Results: Three patients aged 32, 35 and 55 including two men have been concerned. Clinical analysis was done on sciatica with neuropathic occurrences in one case and lumbosciatica in two cases. The Lasegue sign was present in two patients at 45°. All three patients benefited a lumbar computerized tomography (CT scan) highlighting a degenerative disc disease with two in L5S1 space and one in L4L5 space. The imaging has not objectified radicular emerging anomalies. MRI objectified only one big root. A surgical root decompression was realized through interlaminar discectomy approach; foraminotomy and full laminectomy enabling diagnosis in intraoperative period. The evolution was favourable in all three cases with full recession of sympto matology.

Conclusion: This study is the first Senegalese series on the lumbo-sciatica by anomaly of root emergence and highlights especially the difficulties for the diagnosis of these anomalies like other sub-Saharan African countries where expansion of MRI for the diagnosis is low, and still very expensive. MRI provides guidance signs and a large root appearance can warn about the existence of these anomalies. A good root release improves the symptoms.  

Keywords: Conjoined roots, MRI, Surgery
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Type of Study: Case report | Subject: Gamma Knife Radiosurgery
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