Spinal Cord Disc Protrusions and Nerve Compression
The spinal cord is the nerve tissue connecting the brain to the peripheral nervous system. It exists within and is protected by bony structures (vertebrae) of the vertebral column and that are, themselves, separated by discs of softer material. The disc material (nucleus pulpulsus) is encased in and maintained in position by the annulus fibrosus (i.e., the fibrous outer ring). A sufficiently large enough tear in the annulus results in extrusion of pulpulsus beyond the fibrous ring, and thus outside the space in which it is normally contained. Protrusions of disc nucleus can result in compression of the cord itself (central compression) as there is very little “extra room” within the vertebral column to absorb extra mass. More commonly, the compression results in impingement of the nerve rootlets typically where they are exiting through foramen (openings) at each level (segment) of the spine.
Spinal nerve compression medical expert witness specialties include neurosurgery, orthopaedic spine surgery, neurology, pain medicine, interventional radiology, neuropathology, and neuroradiology.