The spinal nerves

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In the lumbar area, the nerve roots emerge from the spine under their corresponding vertebra. Thus the left and right L1 nerve roots come out under the first lumbar vertebra at the L1-2 interspace and so on. The L5 nerve roots come out at the lumbo-sacral junction. The spinal nerves carry messages to the muscles to make the legs work and also carry sensory messages back inside, relaying information from the outside world back to the brain.

As the nerve roots leave the spine they travel out through small canals (intervertebral foraminae) bordered on one side by the facet joint and on the other by the disc. It is less than ideal to have these fragile strands of nerve making their exit right through the machinery of a complex human hinge. It means they run the gauntlet between the very two structures most likely to cause trouble in the spine.

Figure 1.23 The spinal nerve root exiting the spine passes between the disc sucking and blowing on one side and the facet capsule pulling and puckering on the other. This is a precarious arrangement.

As each nerve root goes about its business, it has the intervertebral disc sucking and billowing on one side and the facet joint with its baggy capsule tugging and puckering on the other. The nerve is largely protected from these goings-on by a protective sleeve or nerve sheath which extends just beyond the spine, like the cuff of a shirt poking out from a coat.

As you will read in the next chapter, pathological change of either the disc or facet joint can cause thickening, hardening and swelling.

Figure 1.23 The spinal nerve root exiting the spine passes between the disc sucking and blowing on one side and the facet capsule pulling and puckering on the other. This is a precarious arrangement.

By direct contact, the inflammation can spread to the nerve root, simply because it is so close. Inflammation of the nerve causes severe pain down the leg, known as sciatica.

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