The degenerations resulting from lesions of posterior nerve roots and from transverse lesions of the spinal cord in man : a study of twenty cases / by James Collier and E. Farquhar Buzzard.

Collier, James

Date:: 1903

Credit: The degenerations resulting from lesions of posterior nerve roots and from transverse lesions of the spinal cord in man : a study of twenty cases / by James Collier and E. Farquhar Buzzard. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$far into the anterior horns and breaking up in the neigh- bourhood of the ganglion cells of that part. The oval area in the second lumbar segment was less distinct than in the segment immediately below, and dis- appeared altogether a little higher; it could not be traced spreading out on to the surface of the cord. Lissauer’s tract contained a few very fine fibres, which disappeared rapidly at higher levels. Throughout the thoracic region the degenerated fibres on both sides were separated from the posterior horns by a considerable and gradually increasing undegenerated field. The}^ occupied an area extending from the periphery to the posterior commissure, the anterior portion expanding at first in the commissural region, but later receding towards the median septum until, at the level of the sixth cervical segment, the most anterior fibres did not reach the gray matter, and the whole degenerated field assumed the shape of a triangular wedge, with its base lying on the surface. Above this the degeneration was limited to Groll’s column, and ended in the region of the nucleus gracilis. A very few fibres could be traced laterally above this in the direction of the corpus restiforme, but they broke up near its internal aspect. No degeneration could be traced into the internal arcuate fibres. The Descending Intramedullary Prolongations. The existence of descending posterior root fibres has been shown in human embryos by histological methods and in the adult by means of the degenerations which follow extramedullary root lesions. Their presence in animals (dogs, guinea pigs, &c.) has been proved experi- mentally. The questions which remain to be answered are : {a) Do they exist in large or small numbers? (b) What is their length ? (c) What is their course ? {d) What is their relation to descending fibres of endogenous origin? and {e) What is their mode of termination ? Cases of a single extramedullary root lesion, which can be examined by the Marchi method, and which are not$