Mechanisms of neurovascular compression within the spinal and intervertebral canals☆

Objective: To describe some possible causes of encroachment on human spinal and intervertebral canal (foramen) neurovascular structures. Data selection and synthesis: A review of some imaging films of patients aged 38 to 52 years and some human autopsy histopathologic sections from 40- to 60-year-old cadavers to determine what structures may be responsible for neurovascular compression in individuals in this relatively young-to-middle-age group and to illustrate some examples. Results: Stenosis of the spinal and intervertebral canal neurovascular structures can be caused by various bony and soft-tissue structures. Stenosis can be related to osteophytusis of the vertebral body, uncovertebral joints, and zygapophysial joints and to intervertebral disc protrusion, ossification of the posterior longitudinal ligament, and ligamentum fiavum hypertrophy or buckling. Discussion: Various forms of spinal and intervertebral canal stenosis can cause compression of neurovascular structures that may, in turn, be responsible for symptomatology. Of course, autopsy findings cannot be equated with painful syndromes in patients. (J Manipulative Physiol Ther 2000; 23:107–11)