Neuroradiology
Jon K. Kostelic, BA •¿
Victor M. Haughton, MD •¿
Lowell A. Sether, PhD
Lumbar Spinal Nerves in the Neural
Foramen: MR Appearance'
The appearance of the proximal
lumbar spinal nerves at magnetic
resonance (MR) imaging has not, to
the authors' knowledge, been de
scribed. MR images and exactly cor
responding sections obtained from
four cadavers by means of a freezing
microtome were correlated to char
acterize the MR appearance of the
proximal spinal nerves. The junc
tion of the dorsal and ventral rami
with the dorsal and ventral roots
consists of a group of six to 15 fasci
des measuring 2-6 mm in length.
These fascicles appear in MR images
obtained with short repetition times
as small foci of lower signal intensi
ty than that of surrounding fat. The
proximal spinal nerve and its rela
tionship to the intervertebral disk
and osseous margins of the neural
foramen can be demonstrated effec
tively with MR imaging.
Index terms: Nerves, MR studies, 33.1214 •¿
Nerves, spinal, 33.92
Radiology 1991; 178:837-839
IFrom
theDepartments
ofRadiology
(V.M.H.) and Anatomy (LAS.), Medical Col
lege of Wisconsin (J.K.K.), Froedtert Memorial
Lutheran Hospital, 9200 W Wisconsin Ave.
Milwaukee, WI 53226. Received August 3, 1990;
revision requested September 13; revision re
ceived and accepted October 22. Supported in
part by grant AR33667-04 from the National In
stitutes of Health. Address reprint requests to
V.M.H.
C RSNA, 1991
S ECTIONAL anatomic studies of the
lumbar neural fonamina (1) dem
onstrated that the junction between
the lumbar spinal nerve roots and
the dorsal and ventral nami is a group
of fascicles separated by areolar con
nective tissue containing fat and nu
merous small blood vessels. The exis
tence of the fascicles just distal to the
dorsal moot ganglion explains the ab
sence of a distinct spinal nerve on
conventional panasagittal magnetic
resonance (MR) images of the neural
fomamen. To our knowledge, the MR
appearance of the fascicles that form
the proximal spinal nerve has not
been described. To describe the MR
appearance of the proximal spinal
nerves in the lumbar neural foramina
on the basis of correlations between
MR imaging and anatomic study, we
illustrate the MR appearance of the
plexus of fascicles that constitutes the
proximal 2-6 mm of the lumbar spi
nal nerves.
MATERIALS AND METHODS
Four cadavers aged 45-76 years were
selected from the Body Donation Pro
gram at the Medical College of Wiscon
sin. The cadavers were frozen at —¿20°C
for 3 days, and the lumbar spines and ad
jacent soft tissues were harvested with a
high-speed band saw. The spine speci
mens were vacuum-sealed in plastic,
thawed for 6-12 hours, and then imaged
by means of a 1.5-T Signa imager (GE
Medical Systems, Milwaukee). Images of
sections i mm thick were obtained in a
sagittal plane. An experimental program
that provides spin-echo images with a
small field of view and 4-inch-diameter
sections was used. With this program (MP
222; Andrzej Jesmanowicz, PhD, Milwau
kee) and a solenoid local coil, images
were obtained with a repetition time of
500 msec, an echo time of 38 msec, a 256
x 256matrix,twosignalsaveraged,asec
tion thickness of i mm, and a field of
view of 4 cm2.
The lumbar spine specimens were then
refrozen at —¿20°C
for 3 days and mount
ed on the stage of a freezing microtome
(PMV 2250; PMV, Brömma,Sweden) so
that slices could be obtained in the exact
parasagittal planes that were used for MR
imaging. Tissue was removed with the
blade of the freezing microtome in 33-@zm
sections. Photographs of the cut surface
were obtained as each anatomic landmark
was exposed and after each millimeter of
tissue was removed (i—3).
RESULTS
The anatomic relationships of the
dorsal and ventral nerve roots, the
dorsal and ventral nami, and the five
to 15 fascicles that connect those
structures were well demonstrated
on the parasagittal MR images. The
dorsal and ventral roots, located in
the superior portion of the neural fo
namen (Figs la, 2), appear on MR im
ages as a region of intermediate sig
nal intensity surrounded by the high
signal intensity of fat (Fig le). They
are easily differentiated from trans
vertebral veins, which are located in
the inferior portion of the neural fo
mamma and are characterized by a
low signal intensity at MR. The don
sal moot ganglion is identified as the
bulbous structure in the superior
portion of the neural fomamen (Fig
ib). In the MR images obtained, the
dorsal moot ganglion has an intenme
diate signal intensity (Fig if). The
considerably smaller solitary, oval
ventral moot adjacent to the dorsal
moot ganglion has low signal intensi
ty. Anterior and inferior to the gan
glion is the intervertebral disk, and
posterior to it is the ligamentum fla
vum, which also can be identified at
MR imaging.
The ventral and dorsal roots con
nect with a plexus of fascicles at the
lateral margin of the dorsal moot gan
glion. Over the anterior surface of
the dorsal moot ganglion, the ventral
root bifuncates into superior and in
femiom divisions, which then further
divide into two to five fascicles (Fig
ic). The dorsal moot ganglion con
837
Figure 1. Parasagittal freezing microtome
sections (a-d) and corresponding MR im
ages (e-h) through the L-4 vertebral body
(L4 in a and e) of a 68-year-old woman.
(a, e) The nerve rootslie in the superiorpor
tion of the foramen (arrowheads). The supe
nor (S) and inferior (I) articular processes
posterior to the nerve roots and the inter
vertebral veins (open arrow) inferior to
them are identified. The intervertebral disk
(d) lies anteroinfeniorly. Two millimeters
lateral to a and e (b, f), the ventral root fasci
des (curved arrows) are anterior to the don
sal root ganglion (g) and ligamentum fla
vum (f). In sections immediately lateral to
the ganglion, a plexus of root fascic!es (black
arrows in c and g) is identified. One level
above, the ventral ramus of L-3 (white an
rows) can be seen above the L-4 pedicle. In
sections 1 mm further lateral (d, h), the fas
cicles merge to form the ventral ramus
(black arrows).

nects with five to 10 fascicles. The

seven to 15 fascicles communicating
with the dorsal and ventral moot
make up the proximal spinal nerve
(Fig 2). On a pamasagittal MR image 2
mm lateral to the dorsal root gangli
on (Fig ig), a group of low-intensity
structures seven to 15 in number and
1 mm on less in diameter is identified
in the location at which the freezing
micmotome sections show the fasci
des (Fig ic). The fascicles are lower
(more caudal) in the neural fomamen
and closer to the intervertebral disk
than are the roots. One millimeter
anterior to the fascicles lies the later
al edge of the vertebral body and in
terventebral disk and posteriorly lies
the ligamentum flavum.
Two to five millimeters lateral to
the dorsal moot ganglion, the fascicles
converge into the ventral and dorsal
rami (Fig id). Fascicles originating
from both the dorsal moot ganglion
and the ventral moot converge to
form the ventral ramus, which is evi
dent in the pamasagittal MR image
(Fig ih) and freezing microtome sec
tions (Fig id). The ventral mamus lies
in the inferior portion of the neural
fomamen close to the lateral edge of
the vertebra and ventral to the psoas
muscle. The dorsal mamus is also
formed from fascicles originating
from both the dorsal and ventral
roots.

DISCUSSION
The resolution achieved at MR im coils are scaled for specimens, not for cause little distortion of normal ana
aging in this study is not obtainable clinical studies. Furthermore, physio tomic relationships is produced by
in clinical examinations at present. logic and voluntary motion that may freezing (4). The appearance of vas
The acquisition program that pro be factors in clinical imaging were culam structures in the specimens dif
vides 1-mm-thick sections and small not present in our experiment. The fers from their appearance in vivo.
fields of view is currently experi use of previously frozen tissue does The anatomy of the lumbar neural
mental. The small-diameter solenoid not affect the results significantly be foramina has been described in detail

838 •¿
Radiology March 1991

FASCICLE
VENTRAL RAMUS
Figure 2. Anatomic relationships of the
nerve roots, fascicles, and rami. Fascicles
emerge from the lateral border of the spinal
(dorsal root) ganglion (DRG) and from the
ventral roots (VR) laterally and converge to
form the ventral and smaller dorsal rami of
the spinal nerve proper.
(3,5—8),but the appearance of the
proximal lumbar spinal nerve be
tween the mami and the roots has
only recently been described (1). The
proximal common spinal nerve com
prises seven to 15 small fascicles 2—6
mm in length. The majority of the
fascicles are continuous with the dom
sal root; the remainder, with the yen
tral moot. The dorsal moot ganglion
Volume 178 •¿
Number 3
and ventral root occupy the superior lution MR techniques, the fascicles
portion of the neural fomamina; the and the proximal portions of the yen
fascicles lie centrally in the lateral tral mamus can be distinguished. U
portion of neural foramen approxi
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Radiology •¿
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